Orleans Public Defenders

Volunteer Form

If you are interested in being placed on the “volunteer conflict list” for Orleans Parish Criminal District Court, please read “Orleans Public Defenders 2007 Conflict Panel Rules and Procedures” and complete the application form below.

Name
Date of Birth
Firm Name
Office Address
Mailing Address
Office Phone Number
Fax Number
Email Address
Law School / Date Admitted in LA
LA Bar Roll #
Other States Admitted to Practice
Languages Spoken (excluding English)
Number of Years Practiced Law
Number of Years Practiced Criminal Law
Number of Misdemeanor Cases Tried as Lead Counsel
Number of Felony Cases Handled as Lead Counsel
Number of Cases Tried as Lead Counsel to a Jury
Number of Felony Cases Tried as lead Counsel to a Jury
Number of felony cases tried for which statutory penalty independent of repeat offender status was ten years or more
Number of Capital Cases Handled
Number of Capital Cases Tried
Current Caseload (include separate caseload numbers for misdemeanors, non-capital felonies, capital cases and civil cases)
Willing to accept cases pro bono?	YesNo

Certifications
I hereby certify that I am a member in good standing with the Louisiana State Bar Association and any and all other bar associations, courts, administrative tribunals and/or other entities before which I have been admitted to practice	Yes No
Have formal charges ever been filed against you by the Office of Disciplinary Counsel, the Louisiana Attorney Disciplinary Board or has any similar action been taken by any bar association of another state?	Yes No
Have formal charges ever been filed against you by the disciplinary body of any court, administrative body or other entity before which you function as an attorney?	Yes No
If the answer is yes to any of these questions, please give the details and disposition.

I hereby certify that I have received a copy of the Rules and Procedures of the Orleans Public Defenders Conflict Panel.
I have read said Rules and Procedures and declare that I have the qualifications for listing on the Conflict Panel as set forth therein and herein
I further agree to abide by said Rules and Procedures.
I understand that this application is continuing and I will report within no more than seven days after they occur, all future occurrences that may materially alter the accuracy of the information provided herein, including, without limitation, all notices relative to standing with the Louisiana State Bar Association, the Office of Disciplinary Counsel or the bar, court or administrative body of any other entity or association of any other state.

By submitting this form, I certify that I have read and agree to the “Orleans Public Defenders 2007 Conflict Panel Rules and Procedures” and that that the information provided on this form is accurate.”