Contract Counsel Reference

Attorney Name:

Missouri Bar #:

Street, PO Box, Suite:

City State Zip:

Telephone

Fax:

E-mail Address:

To assist us in making assignments to you, we would appreciate your answering the following questions. Please email this form to

Have you ever worked as an employee for, or in a contract, clinical or volunteer capacity with the Missouri Public Defender System?

If yes, indicate type of work:

P. D. Office:

Immediate supervisor:

Cases

I wish to be considered for number of cases per year?

I wish to be considered for the following type of cases:[X next to appropriate ones]

Trial Level cases:

Misdemeanors:

C & D Felonies:

A & B Felonies:

Death Penalty:

Murder 1st/Non-Death

PCR Cases:

PCR Type:

Appeals:

Appeals Type:

All counties I will take cases in:

General Background Information

1)  How many years have you been a licensed member of the Missouri Bar?

2)  List three [3] References: Two [2] Previous Employers and [1] Additional Legal Professional who is familiar with your work.

Name: / Name: / Name:
Address / Address / Addres
Phone: / Phone: / Phone:
Relationship: / Relationship: / Relationship:

3)  Please indicate the approximate number of felony cases you have handled:

4)  Please indicate the number of jury trials you have completed. List Cause, Case No. & County for the three [3] most recent cases if you have not been a Missouri State Public Defender in the last two years.

a)  # of Civil jury trials?

Cause: / Cause: / Cause:
Case No: / CaseNo: / CaseNo:
County: / County: / County:

b)  # of Misdemeanor trials?

Cause: / Cause: / Cause:
Case No: / CaseNo: / CaseNo:
County: / County: / County:

c)  # of Felony bench trials?:

Cause: / Cause: / Cause:
Case No: / CaseNo: / CaseNo:
County: / County: / County:

5)  # of Felony jury trials?:

Cause: / Cause: / Cause:
Case No: / CaseNo: / CaseNo:
County: / County: / County:

6)  Please indicate the charge[s] for the most serious criminal case that you have handled and the Cause, Case No., County and disposition.

a)  Non-jury trial Charge?

Cause:
Case No:
County :

b)  Jury trial:Charge?

Cause:
Case No:
County :

c)  Plea disposition Charge?:

Cause:
Case No:
County :

7)  Number of appellate cases handled. List Cause, Case No. and County for the three [3] most recent cases, if you have not been a Missouri State Public Defender in the last two years.

8)  # of Civil appeals?:

Cause: / Cause: / Cause:
Case No: / CaseNo: / CaseNo:
County: / County: / County:

9)  #of Felony appeals?:

Cause: / Cause: / Cause:
Case No: / CaseNo: / CaseNo:
County: / County: / County:

10) Please indicate any other relevant experience involved with criminal actions, noting the approximate number of cases handled in the following categories and the Cause Name, Court and Case No. for one:

# of State post conviction action?:

Cause:
Case No:
County :

# of State habeas corpus action?:

Cause:
Case No:
County :

# of Federal habeas corpus action?

Cause: this ia s atest aslkdjfkasjdf a askdjf a;sldkjfaklsj dfalskdjf
Case No:
County :

OPTIONAL: Add any additional information that you would like about your qualifications for the type of cases you would like to receive. Feel free to also email an Resume.