PRO BONO PROGRAM ENROLLMENT FORM

The Middle District Chapter of the Federal Bar Association has established a pro bono program in cooperation with the United States District Court, Middle District of Pennsylvania that provides attorneys to represent indigent parties in civil litigation after the Court has preliminarily evaluated the case and made a determination to seek counsel for that party. The program is administered for the Court by the Chapter's pro bono chair. Attorneys who are generally admitted to practice in the Middle District of Pennsylvania are encouraged to enroll in the Chapter's pro bono panel by completing this form; however, completion of this form is not a requirement for admission to the bar of the United States District Court for the Middle District of Pennsylvania. It is also not necessary to join the Federal Bar Association to be part of the Court's ongoing efforts to maintain a pool of attorneys to assist indigent civil litigants. If you are willing to be a part of this important program, please complete this form and return it to the FBA's pro bono program chair at the address provided below.

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ENROLLMENT IN PRO BONO PANEL

I am willing to consider undertaking pro bono appointments from the Court, given reasonable advance notice. I understand that these appointments mean that the Court has already screened the case to some degree and believes that there may be merit in the underlying action. I also understand that there may be opportunity to request attorney's fees and costs allowable to a prevailing party in conformity with applicable statutes and rules of court.

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(Signature)                      

Name: _______________________________________________________________________

Firm: _______________________________________________________________________

Mailing Address: _______________________________________________________________________

                      _______________________________________________________________________

Telephone: _______________________________________________________________________

Fax Number: _______________________________________________________________________

E-Mail Address: _______________________________________________________________________

Date of First Bar Admission
(to a state court): _______________________________________________________________________

Today's Date: _______________________________________________________________________