Application for Candidate for Supreme Court Justice (07/2019) Page 1 of 17
APPLICATION FOR CANDIDATE FOR SUPREME COURT JUSTICE
Date of application: ______________________________________________________________________
Position applied for: ______________________________________________________________________
NOTE TO APPLICANT: Please submit ONE cover page that includes your Social Security Number, for the
purpose of performing a criminal background check.
GENERAL
1. Name: ___________________________________________________________________________
2. Mailing address: ___________________________________________________________________
Business address: __________________________________________________________________
Email address: _____________________________________________________________________
3. Date of birth: ______________________________________________________________________
4a. Are you a Vermont resident (see 4 V.S.A. § 602(c)(1))? ☐ Yes ☐ No
4b. Town of primary residence: ___________________________________________________________
5. Telephone nos. Home: _______________ Business: _______________ Cell: _________________
6a. Years practicing law in the State of Vermont (minimum 10 years per (4 V.S.A. § 602(c)(1)):________
6b. Have you practiced law in Vermont for a least five years immediately preceding this application (see 4
V.S.A. § 602(c)(1))? ☐ Yes ☐ No
6c. If the answer to b. above is NO, are you seeking an exception to the fiver-year requirement in (4 V.S.A. §
602(c)(1))? If so, please explain the basis for seeking this exception. Note: The Board may make
exceptions to the five-year requirement for absences from practice for reasons including family, military,
academic, or medical leave.