VAP Registration

Name*
First Middle Last
Name of Firm
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax
Email*
Month/Year admitted to MN bar:*
Attorney License Number*
I wish to receive emails on free and reduced cost CLEs and other volunteer benefits:
- Yes
- No
Service Area*
I would like to work with the Volunteer Attorney Program from the following office:
- St. Cloud
- Willmar
St. Cloud Office
I will accept cases venued in the following counties (check all that apply):
- Anoka (Mediation Only)
- Benton
- Chisago
- Isanti
- Mille Lacs
- Morrison
- Sherburne
- Stearns
- Todd
Willmar Office
I will accept cases venued in the following counties (check all that apply):
- Big Stone
- Chippewa
- Kandiyohi
- Lac Qui Parle
- Lincoln
- Lyon
- Meeker
- Renville
- Swift
- Wright
- Yellow Medicine

Volunteer Cases
- I would like to assist eligible clients with advice, brief services, and full representation cases. Please refer the following cases to me (see next page):
- I am also interested in information about the Contract Program, where VAP pays the volunteer attorney a reduced hourly rate to represent eligible clients in certain Family Law matters.
Legal Advice Clinics
I would like to volunteer at the following legal advice clinics:
- Isanti County Legal Advice Clinic (2nd Monday of each month from 1 p.m.-4 p.m.)
- Kandiyohi Legal Advice Clinic (Fridays from 12 p.m.-1 p.m.)
- Sherburne County Legal Advice Clinic (2nd Wednesday of each month from 12 p.m.-1 p.m.)
- Stearns County Legal Advice Clinic (Tuesdays from 12 p.m.-1 p.m.)
- Wright County Legal Advice Clinic (Thursdays from 12 p.m.-1 p.m.)
Additional Opportunities
- Community Education Presentations
- Mentoring New Attorneys

Miscellaneous
- Immigration
- Criminal Expungements
- Housing Expungements
- Other Civil Legal Issues (please list below):

I hereby agree to adhere to the Central Minnesota Volunteer Attorney Program Policies and Procedures, a copy of which I have received.*
I certify by signing that I have a valid license to practice law in Minnesota.*
Date*
MM slash DD slash YYYY