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ILLINOIS SUPREME COURT VOLUNTEER PRO BONO PROGRAM ATTORNEY (Administrative Office of the Illinois Courts)

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BROWSE ADMINISTRATIVE OFFICE OF THE ILLINOIS COURTS (IL) FORMS

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ILLINOIS SUPREME COURT
VOLUNTEER PRO BONO PROGRAM ATTORNEY APPLICATION
ISC-VQ 100.3
Page 1 of 3
(06/20)
1. Name: ______________________________________________________________
2. Business Address: _____________________________________________________
3. Contact Information:
____________________________ ________________________________
Phone Email
4. Firm name (if applicable): _______________________________________________
5. Firm’s Pro Bono Counsel Contact Information (if applicable):
____________________________ ________________________________
Name Email
____________________________
Phone
6. Bar Admissions:
State(s): _____________________ Date(s) of Admission: ______________
Federal: _____________________ Date of Admission: ________________
Are you currently admitted pro hac vice in Illinois? □ Yes □ No
(If yes, provide a copy of the order granting admission)
7. ARDC Number (and other state registration numbers, if applicable):
____________________________________________________________________
8. Do you currently maintain malpractice insurance? □ Yes □ No
9. Has your license or right to practice law before any state or federal court, agency, or
other tribunal ever resulted in censure, probation, suspension, or disbarment?
□ Yes □ No
ILLINOIS SUPREME COURT
VOLUNTEER PRO BONO PROGRAM ATTORNEY APPLICATION
ISC-VQ 100.3
Page 2 of 3
(06/20)
If yes, please briefly describe the nature, date, and result of the proceedings.
Please include the ARDC number and date of disposition (attach additional pages as
necessary).
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
10. Have you appeared as appellate counsel in at least 2 cases in civil and/or criminal
appeals? □ Yes □ No
If yes, your experience is in: State Court: □ Yes □ No Federal Court: □ Yes □ No
If yes, how many criminal felony cases have you handled as counsel?
□ 0 □ 1-5 □ 6-10 □ over 10
11. Have you previously clerked for a federal or state reviewing court judge, or worked in
the Appellate Division for the OSAD, the State’s Attorney, the US Attorney, or the Office
of the Attorney General for at least 2 years? □ Yes □ No
If yes, for whom, where, and for what years? ________________________________
______________________________________________________________________
______________________________________________________________________
12. If you do not have prior appellate experience as counsel, state the name, address, and
phone number of the attorney who has been approved as a volunteer Pro Bono Program
Attorney under whose supervision you will work or list the date you completed the
online training course administered by OSAD (skip, if not applicable):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
13. In what Appellate Districts are you willing to handle cases?
______________________________________________________________________
ILLINOIS SUPREME COURT
VOLUNTEER PRO BONO PROGRAM ATTORNEY APPLICATION
ISC-VQ 100.3
Page 3 of 3
(06/20)
CERTIFICATION, AUTHORIZATION FOR RELEASE, AND WAIVER
I authorize the Administrator of the Attorney Registration and Disciplinary Commission
and the Illinois Supreme Court to disclose to its Administrative Office all information contained
in the files of the Attorney Registration and Disciplinary Commission concerning my present
status, any complaints which have been made against me, the disposition of those complaints,
and the contents of this application. I expressly waive any right to confidentiality I may possess
with respect to this information.
I authorize the Illinois Supreme Court, the Administrative Office of the Illinois Courts, or
individual appointed by it to discuss the contents of this application with any judge, attorney, or
individual deemed appropriate for the purpose of evaluating my application to the Illinois
Supreme Court’s Pro Bono Program.
I recognize, accept, and agree that any attorney or judge, who is contacted by the
Administrative Office of the Illinois Courts or other individual appointed by the Illinois Supreme
Court to investigate or evaluate my application, must supply the requested information in
fulfillment of his or her professional responsibilities. Information supplied is subject to privilege
and may not be the basis for any claim or cause of action whatsoever on my part.
I agree that any person furnishing information concerning my fitness for admission to the
Illinois Supreme Court’s Pro Bono Program shall be immune and held harmless with respect to
any claim or action by myself. I hereby expressly waive and agree to forego any claim or cause
of action against any person providing or receiving any information related to my application to
or participation in the Illinois Supreme Court’s Pro Bono Program and expressly agree to hold
harmless all such people.
I certify all statements made in this application are true, complete, and correct.
Name (please print clearly): ___________________________________________________
Signature of Applicant: _______________________________________________________
Date of Signature: ___________________________________________________________
Please return the application to:
Administrative Office of the Illinois Courts, Attention - Gabriela Conley, 222 N. LaSalle, 13
th
Floor,
Tel. 312-793-2558 or Email gconley@illinoiscourts.gov
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ILLINOIS SUPREME COURT VOLUNTEER PRO BONO PROGRAM ATTORNEY (Administrative Office of the Illinois Courts)

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Completed 13 August 2020

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