Intake Form

If you are interested in exploring your eligibility, please complete this intake form, which will be forwarded to Lawyers for Civil Rights or Lawyers Clearinghouse, as applicable, upon completion. Please complete all fields.

After you have provided the information requested in the intake form, Lawyers for Civil Rights or Lawyers Clearinghouse will determine your eligibility for pro bono legal services.

Name of organization Name of person submitting application Address of organization Contact email address Contact phone number Brief description of organization Is your business for profit or non-profit? If non-profit, please specify type of non-profit (e.g., 501(c)(3), 501(c)(7), etc.)) Legal structure of organization (e.g., sole proprietorship, partnership, LLC, corporation, other) Has the organization been in operation for less than two years? Does the organization have greater than 500 employees? Did the organization make a profit in 2019? Has the organization experienced a substantial loss as a result of the COVID-19 pandemic? Is the organization owned by a veteran? Is the organization owned by a woman? Is the organization owned by any other socially or economically disadvantaged individuals? Please enter any other information that you feel may be relevant.