MAVL Pro Bono Lawyer Self-Reporting Form

Mountain Area Volunteer Lawyer (MAVL) Program
“Private” Pro Bono Self-Reporting Form

If you have rendered private pro bono services to low-income clients outside the MAVL Program, please complete this form so that MAVL may record your pro bono service to low-income residents of Buncombe, Henderson, Madison, Polk, Rutherford and Transylvania counties. The following client information will be kept confidential.

With client approval, I am reporting the following information to MAVL about private pro bono service I have provided:

MAVL Self Reporting Form

Client Name*
First Last
Address
Street Address Address Line 2 City State ZIP Code
Age*
# of Adults in Household Affected by Legal Result/Representation
# of Children in Household Affected by Legal Result/Representation
Ethnicity*
- White
- African-American
- Hispanic
- Other
Monthly Income $
Services Donated
Time Donated (hours)*
Attorney Name*
First Last
Attorney Address*
Street Address Address Line 2 City State ZIP Code
Date of Report
Name
This field is for validation purposes and should be left unchanged.

MAVL Self-Reporting Form

Mountain Area Volunteer Lawyer (MAVL) Program “Private” Pro Bono Self-Reporting Form

MAVL Self Reporting Form

Mountain Area Volunteer Lawyer (MAVL) Program
“Private” Pro Bono Self-Reporting Form