2013 PBA Pro Bono Awards Nomination Form

2013 PBA Pro Bono
Awards Nomination Form

Please return this form no later than Thursday, April 12, 2013 to: David Keller Trevaskis PBA, 100 South Street, P. O. Box 186, Harrisburg, PA 17108-0186 Or via Fax: 717-238-7182 or via E-mail to david.trevaskis@pabar.org

Name of Nominee:
Pro Bono Award (Please answer all questions below)
Judges Award (Please answer questions 1, 7-10 only, and email supporting documents to: David.Trevaskis@pabar.org or mail to: PBA Pro Bono Office, PO Box 186, Harrisburg, PA 17108)
Civil Legal Aid Attorney of the Year Award (Please answer questions 1, 7-10 only, and email supporting documents to David.Trevaskis@pabar.org or mail to: PBA Pro Bono Office, PO Box 186, Harrisburg, PA 17108)
Pro Bono Partner Award (Please answer questions 1, 7-10 only, and email supporting documents to David.Trevaskis@pabar.org or mail to: PBA Pro Bono Office, PO Box 186, Harrisburg, PA 17108)
Employer
Work Address:
Work Phone:
Fax:
Email:
Cell (if available):
1. Why does your nominee deserve the award for which he or she is being nominated?:
2. Does the nominee provide free legal assistance through a pro bono program; i.e., legal aid society, local bar association, pro bono project, lawyer referral service no-fee panel, etc? Yes
No
If yes, name of program(s)
If no, please explain the source of the pro bono work:
3. Please estimate the number of pro bono hours donated in the last year:
4. Number of clients served in the last year as a result of nominee’s pro bono activities:

5. What are the nominee’s principal areas of practice?

6. Please specify in which areas of practice the nominee’s contribution has been made:

7. How did this nominee's service help promote civil legal aid? Is there any other information you wish to provide about the nominee?

8. Are there any stories of this person's work in the field that you can share? Can you provide any quotes from civil legal aid clients? Can you add any comments from peers in the field?

9. Does the nominee know he/she is being nominated for this award? Yes
No
10. Name of Person and/or organization submitting this nomination, full contact information:
Organization:
Address:
Phone:
Fax:
Email:

Please complete and return this form no later than Thursday, April 12, 2013 to: David Keller Trevaskis PBA, 100 South Street, P. O. Box 186, Harrisburg, PA 17108-0186 Or via Fax: 717-238-7182 or via E-mail to david.trevaskis@pabar.org

For security reasons,
please enter the following 5 letters
RNXIE
then click the submit button.