The Massachusetts Supreme Judicial Court
Pro Bono Recognition Program Certification for Law Students
Name of law student:
_______________________________________________________________________________________________
Mailing Address:
_______________________________________________________________________________________________
Telephone Number:
_______________________________________________________________________________________________
E-mail Address:
_______________________________________________________________________________________________
Certified by: ____________________________________________________________________________________
Title: __________________________________________________________________________________________
Telephone number and email address:
_______________________________________________________________________________________________
Law School:
_______________________________________________________________________________________________
Address:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
BY MY SIGNATURE BELOW, I CERTIFY THAT __________________________________ HAS
COMPLETED A MINIMUM OF FIFTY HOURS OF PRO BONO SERVICE OVER THE COURSE
OF THE STUDENT'S LAW SCHOOL CAREER.
Signature: _________________________________________________ Date: __________
Please return completed certification by email to: mb.sjcprobono@jud.state.ma.us, referencing Pro Bono Honor Roll in the subject line,
or by mail to: Chip Phinney, Deputy Legal Counsel, Supreme Judicial Court, One Pemberton Square, Boston, MA 02108. A single form
may be submitted with an attached list of qualifying law students, provided that the list includes the mailing address, telephone number,
and e-mail address for each student.
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