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ATTORNEY Funding Application
     
  Law Firm Information
     
  Law Firm Name
  Address
  Address Line 2
  City
  State
  Zip
     
  Primary Contact Information
     
  First Name
  Last Name
  Telephone - Ext
  Fax -
  Email
  Please Answer The Following Questions:
     
  Our law firm is a...  
     
  Corporation Personal Corporation
  Limited Liability Company Partnership
  Limited Liability Partnership Sole Proprietorship
 

Other-please specify

     
  How many of the following does your firm currently employ?
     
  Partners/Members
  Associates
  Paralegals
  Controller/Bookkeepers
  Other employees
     
  Please describe your practice areas:
 
 

How many cases (approximately) does
your firm have currently pending?

     
 

Amount of Funding Requested?

$