Consulate General of Nigeria, New York 828 Second Avenue, New York, New York 10017 Tel: (212) 850-2200 Fax: (212) 687-1476 http://www.nigeriahouse.com VOLUNTEER ATTORNEY REGISTRATION FORM PERSONAL INFORMATION Last Name First Name Middle Initial Previous Name Title (Honorable/Mr./Mrs./Ms.) Gender Employer Business Address City State Zip Business Telephone ( ) Fax ( ) E-Mail Address Website Address: Home Address City State Zip Home Telephone ( ) Fax ( ) Mobile Phone Preferred Mailing: Business Home BAR ADMISSIONS Date of Admission (MM/DD/YYYY) Jurisdiction Date of Admission (MM/DD/YYYY) Jurisdiction Date of Admission (MM/DD/YYYY) Jurisdiction
If you are admitted to more than one Bar, please state the Bar under which you currently practice law If you are admitted to more than one Bar and do not currently practice law, please state the Bar under which you most recently practiced law Have you ever been disbarred, disciplined or the subject of any disciplinary action/ inquiry? Check one Yes No (If yes, please attach details) LAW SCHOOLS/TERTIARY INSTITUTIONS Law School Graduation Date Law School Graduation Date Other Institution: Degree Graduation Date Other Institution Degree Graduation Date TYPE OF EMPLOYMENT Solo Practitioner Law Firm (2-20 Lawyers) Law Firm (21-60) Law Firm (60+) Public Sector Academia Judiciary Corporation Other (specify below) PRACTICE AREAS Please list by up to four areas that best describe the type of work in which you are presently engaged or are interested in (see attached list of practice areas),, CATEGORY REGISTERED FOR SUGGESTIONS AND INNOVATIONS ON HOW: i. THE CONSULATE SHOULD ORGANISE AND SUPPORT NNIGERIANS IN THE UNITED STATES, AS WELL AS TO MOVE NIGERIA FORWARD: 2
ii. YOU MAY WISH TO CONTRIBUTE TOWARDS NIGERIA S PROGRESS (E.G. IMPROVING NIGERIA S JUDICIAL SYSTEM, DONATION OF LAW BOOKS AND JOURNALS TO LAW FACULTIES, TEACHING, MENTORING AND INTERNSHIPS OF UNIVERSITY LAW STUDENTS. DONATION OF COURT REPORTING /STENOGRAPHIC AND VIDEO CONFERENCING EQUIPMENT: iii. ON HOW YOU MAY WISH TO ASSIST DETAINED NIGERIANS, NIGERIAN ASSOCIATIONS AND BUSINESSES IN THE, IN NEED OF LEGAL ASSISTANCE: iv. ANY OTHER REMARK(S) Signature Date 3
List of Practice Areas Administrative and Regulatory Admiralty Antitrust Appellate Practice Arbitration-Mediation Art Aviation Banking Bankruptcy Child Welfare/ Juvenile Justice Civil Litigation Civil Rights Commercial Commercial Contracts Communications Computer and Technology Law Condemnation Constitutional Law Construction Consumer Affairs Corporation Criminal Customs and International Trade Law Education Law Elder Law Election Law Employee Benefits Employment Law Energy Law Entertainment Law Environment Estate Planning Estates, Trust and Surrogates Court practice Family and Matrimonial Federal Courts Finance Franchising General Practice Government Contracts Government Counsel Government- NYC Health Immigration and Naturalization In-House Counsel Insurance Intellectual Property International Law Judicial Administration Labor Law Land Use and Zoning Landlord-Tenant 4
Law Office Management Lawyer Placement and Professional Development Lawyers Professional Liability Legal Education Libel Medical Malpractice Mergers and Acquisitions Military Law Municipal Bonds Non-Profit Organizations Patents Personal Injury Probate Product Liability Professional Discipline and Ethics Public Interest Public Utilities Law Real Estate Secured Lending Securities Sports Law Taxation-Corporation Taxation-Estate Taxation-Personal income Tort Law Trademark and Copyright Transportation Urban Development Utilities Women s Rights Worker s Compensation CATEGORIES: Admitted for less than 2 years { } Admitted for less than 5 but over 2 years { } Admitted for 5 or more years { } Law Graduates but not called to any Bar { } Law Graduates called to Foreign Bars { } Law Students (Interns) { } Paralegals { } Volunteer Research Fellows { } 5