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PBF Attorney Submission

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First Name

Last Name

Phone

Email

Bar Admission State(s)

Years of Legal Experience

Name of Firm

Firm Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

What is your area of expertise? (choose all that apply)

Criminal Law

Civil Law

Family Law

Employment Law

Personal Injury

Other (Please specify)

Other Expertise

Do you have knowledge of the Troubled Teen Industry?

Do you have experience litigating child abuse cases?

What assistance would you offer? (choose all that apply)

Representing youth currently placed in programs

Representing parents/families advocating for a youth placed in programs

Impact litigation

Whistleblower protection/ Employer retaliation

Paralegal Services

Legal Advice

Assisting with the educational component of Project Break Free as a guest speaker on the educational webinars

Other (please describe below)

Other Assistance

Are you willing to provide pro-bono or contingency legal services?

Pro-Bono

Contingency

Either or depending on case

Discounted Retainer/ hourly rate

Other (please describe below)

Other Assistance

Hours of Availability (please specify: per week/ month or case)

By Submitting this form you consent to the use of your information for the purpose of offering services, news and updates related to participation in the Project Break Free Program.