Project Break Free - Application

If you or your loved ones are facing legal challenges, our team of dedicated attorneys is here to support you. We offer pro-bono and contingency-based legal services for a variety of cases, including representing youth in programs, advocating for families, and litigating impactful cases.

PBF Client Sign Up

First Name

Last Name

Phone

Address (Optional)

City

State

Zip Code

Preferred Method of Communication

Phone

Mailing Address

What identification best describes you?

Survivors: Please note that your personal injury cases may be added to a list of potential class action/ mass action or impact litigation list. Please expect a delay in taking on your case as it would be up to the attorney to invite you to participate. Your information will only be shared with a licensed attorney, and you will only be contacted by the firm filing the case.

Case Information

Other Assistance:

Brief Description of the Case:

Date of Incident/ Dates of Internment

Year

Parties Involved

Name of Program

State/ Country of Program

Opposing Party/ Parties

Relationship to Opposing Parties

Legal History

Have you previously sought legal assistance for this matter?

If yes, please provide details

Are there any existing court orders or legal proceedings related to this case?

If yes, please provide details

Do you have any documents related to the case?

Can you provide copies of these documents?

Supportive Documentation

Choose File

Is there any other information you believe is important for us to know?

Acknowledgment and Consent

I hereby acknowledge that the information provided is true and accurate to the best of my knowledge.

Signature (Your Legal Name)

Date:

By Submitting this form you consent to the use of your information for the purpose of requesting services, news and updates related to participation in ICAPA Network's Project Break Free legal Assistance referral program. Applying does not guarantee legal representation. You will be contacted by the attorney if your case has been selected.