Pro Bono Services Volunteer Application
 
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KING COUNTY BAR ASSOCIATION
PRO BONO SERVICES

Volunteer Application


Contact Information:
Date: 8/30/2014
 *Last Name:  *First Name: Middle Initial:
 *Preferred Address:  *City:  *Zip Code:
 *Phone Number for PBS Staff:   Phone Number for Clients:
 *E-mail: Fax:

 

Volunteer Classification:
 *

 

Attorneys Only:
Are you licensed to practice in Washington State? WSBA #:
Are you licensed to practice in ANOTHER STATE?
State: Bar #
Have you ever been sanctioned, disciplined or reprimanded by a Bar Association?
Please explain:
Number of years in practice?
Practice Areas:
Are you a KCBA Member?
Law School:

 

All Volunteers:
Prior experience/training in legal aid work?
Please describe:
Fluent in language(s) other than English?
Language(s):
* Preference for working with a specific low-income population?








 

Volunteer Program Preference:
Review position descriptions prior to making selection: time commitment, benefits, and required training vary.

Please select no more than two volunteer programs.


- Mentor, Mentee
  Previous work with domestic violence survivors?
Please explain:
  Do you plan to make family law a part of your practice?

- Attorney, Legal Assistant
Resume and cover letter required.
  HJP Clinic Preference:


- Attorney
  Prior family law or dependency law experience?
(prior experience not required)
Please explain:

NLC Attorney Location:
NLC Clinic Assistant Location:
NLC Intake and Referral Intern

- Experienced Attorneys Only - Attorney
  Previous work with domestic violence survivors?
Please explain:

- Experienced Attorneys Only
Attorney, Advisor





Bankruptcy Cases - Are you licensed to practice in Federal Court?
Will Cases - Can you do home or hospital visits?

- Description
Previously published?
Please explain:
Topics of Interest:
Submission Frequency:

Leave a Comment:

 

New Volunteer Orientation (required):
The volunteer orientation is your opportunity to learn more about KCBA's Pro Bono Services programs, volunteer policies and support, and the legal resources available to PBS volunteers. We will also review your program placement status.

Time: 5:00p.m. to 6:00p.m. Location: KCBA Office, 1200 Fifth Avenue, Ste. 600, Seattle, WA 98101

 *Orientation Registration Date:
How soon do you wish to begin volunteering?

 

CONFIDENTIALITY AGREEMENT

As a KCBA employee, work-study student, intern, extern, volunteer, or student observer, I understand that I may have access to confidential information regarding clients seeking legal assistance from one of the Pro Bono Services Programs. This information may be in a written form, an electronic format, or may be given verbally during intake. Examples of confidential information include but are not limited to names, addresses, telephone numbers, medical, psychological, health-related conditions and treatment, religious beliefs, finances, living arrangements, social history, the HIV status of a client, and/or facts regarding their legal circumstances. By agreeing to this statement, I am indicating my understanding of my responsibilities and agree to the following:

  • I agree to uphold the confidentiality and security policies of the King County Bar Association.
  • I agree not to divulge, publish, or otherwise make known to unauthorized persons or to the public any information obtained that could identify persons seeking legal assistance.
  • I understand that all client information compiled, obtained, or accessed by me in the course of my work is confidential. I agree not to divulge or otherwise make known to unauthorized persons any information regarding the same, unless specifically authorized to do so by the client.
  • I understand that I am not to read information and records concerning patients, clients or study participants, or any other confidential documents, nor ask questions of clients during interviews for my own personal information but only to the extent and for the purpose of performing my assigned duties.
  • I understand that a breach of security or confidentiality may be grounds for disciplinary action by KCBA, and may include termination of employment.
  • I understand that the civil and criminal penalties set forth in the Revised Code of Washington (RCW 70.24.080 and 70.24.084) include, for each breach of STD/HIV records, a fine of $1000 or actual damages for negligent violation and $10,000 or actual damages for intentional or reckless violation, which I would be personally responsible for paying.
  • I understand that action to impose civil or criminal penalties against me may be taken by a prosecuting attorney or another party with standing if I am suspected of being responsible for a breach of confidentiality.
  • I agree to notify my supervisor immediately should I become aware of an actual breach of confidentiality or a situation which could potentially result in a breach, whether this be on my part or on the part of another person.





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King County Bar Association
1200 5th Ave, Suite 600
Seattle, WA 98101
Main (206) 267-7100
Fax (206) 267-7099

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