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March 13, 2010

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APPLICATION FOR COMMITTEE APPOINTMENT

Please Note: This form is to be completed by persons wishing to be considered for appointment to a State Bar of Arizona Committee.

Fields with * are required.

*First Name:		*Last Name:		*Bar Number:
*Firm/Agency/Employer:

*Address:

*City:

*Zip:

*County:

*E-mail:

*Office Telephone:


In order to keep State Bar committees balanced, it is vitally important that you complete this portion of the application thoroughly.

Which of the following best describes your current occupation?
	Private practice	Corporate law department	Civil	Plaintiff	Defense
	Publicly employed	Non-governmental legal services organization	Criminal	Prosecution


What is the size of your office?
	Solo Practitioner	2-10 lawyer office	11-35 lawyer office	35+ lawyer office

Fields in which you practice:

Date admitted to the State Bar of Arizona:		Length of time in practice:

I request appointment to the following Committees: (in order of preference)	Description of Committees Click here.
1. 2.
3.
4.
Separate application for appointments committee is needed. Learn more.

I am currently serving on the following SBA committees:
Committee:		Length(yrs)
1.
2.
3.
I have previously served on the following SBA committees:
Committee:		Length(yrs)
1.
2.
3.
Please paste or type your resume:

CONFIDENTIAL

In order to make appointments that will achieve diversity and broad representation on State Bar committees, we are giving you the opportunity to complete this portion of the Appointment Application.
The following information is not required, and any decision not to complete this portion of the application will not adversely affect your chances for appointment.

Please indicate which one of the following categories
used by the EEOC best describes you.
Your Age Male Female
Asian Native American or Alaskan Native
Black or African American Hispanic or Latino
Caucasian
Two or more races
Native Hawaiian or other Pacific Islander
If the above designations do not best describe you,
please set forth the description you prefer:

If you have any questions, please contact
602-340-7239