Pro Bono Self Reporting

If you have rendered private pro bono services to low income clients outside the Mountain Area Volunteer Lawyers (MAVL) Program, please complete this form so that MAVL may record your pro bono service to low-income residents in Buncombe, Henderson, Madison, Polk, Rutherford & Transylvania Counties. The following client information will be kept confidential.

(This information will be retained in the database of the Buncombe County Bar website and delivered to MAVL only.)

* indicates required information

Pro Bono Self Reporting Form

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

I have acquired approval.

Personal Attorney Data:

Email Address

First and Last Name *

Address *

City *

Zip *

Phone Number

Client Data

Name of Client *

Client's Street Address *

Client's City *

Client's Zip Code *

Client's Age *

Number of Adults in Household Affected by Legal Result/Representation *

Number of Children in Household Affected by Legal Result/Representation *

Client Ethnicity (check all that apply) *

White

African American

Hispanic

Other

Client Monthly Income *

Hour Reporting

Number of Hours Donated *

Date *

reCAPTCHA