County Bar Association:

Your name and title:

Address:

Telephone Number:

Title of Project:

Project Category:

Improvement of the Legal Profession

The Justice System

The Community

Project Initiated (month and year)

Project Completed (when?)

Project Continuing (project must have been in operation during 2004)

Please write a general description of the project that you are submitting and a brief analysis of positive effects:

Name and title of county bar representative who will be present at the CCBL Annual Seminar to accept the award:

Suggested media in your county to receive news releases and photograph of award presentation: