1
ATTORNEY APPOINTMENT LIST APPLICATION
(Civil Law - Mediators)
Denton County District Courts
Name: _____________________________________ Date of Application: ____________
Bar Card Number: _________________________ Date Licensed: ____________
Business Mailing Address: ______________________________________________________
Business Physical Address: ______________________________________________________
Home Phone: __________________________ Cell Phone: ________________________
Business Phone: ____________________ Fax Phone: ________________________
Email Address: ____________________
I am requesting my name be placed on:
Civil Law - Mediators:
Are you fluent in any language other than English? Yes No
Which languages? ____________________________________________________________
If yes, do you wish to be listed as a foreign language attorney? Yes No
CHARACTER, REPUTATION AND CONFLICTS
Are you currently a member in good standing of the State Bar of Texas?
Yes No
Have you been publicly sanctioned or reprimanded by the State Bar of Texas within the last three
(3) years?
Yes No
If yes, attach decisions by the committee and, if desired, any written explanations.
Are you a magistrate, city judge, assistant city judges, or any city, county, or state official?
Yes No If yes, where and in what capacity?
______________________________________________________________________________
______________________________________________________________________________
