CCJ: Collaborating Counsel Network Form

CONTACT INFORMATION
Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Company*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
LEGAL TRAINING & EXPERIENCE
Law School*
Year JD Conferred *
Please list all State Bar Admission(s) and corresponding license number(s) - Example: CA #12345678*
Please list Federal Bar Admission(s) - Example: United States Court of Appeals for the First Circuit
Affiliation with CCJ:
Please list Professional Organization & Bar Association Memberships - Example: Federalist Society, American Bar Association
Clerkships:
Position
Court
Judge
Dates
Additional information on Clerkships can be emailed to CCJ@Claremont.org.
Have you ever been convicted of a felony?*

YesNo
Have you ever received any form of discipline from a court or a lawyers disciplinary authority since you were first admitted to practice law?*

YesNo
Have you ever been denied admission or readmission to the bar of any court?*

YesNo
Are there disciplinary proceedings presently pending against you?*

YesNo
If you answered yes to any of the four preceding questions, please provide an explanatory statement on the nature of your actions via email to CCJ@Claremont.org.
COLLABORATING WITH CCJ
I am willing to consider helping your efforts by (check all that apply):

Initial researchWriting briefsCollaborating with CCJ attorneys on all aspects of the caseHaving CCJ hand off a case to me entirely
I am willing to consider collaborating with CCJ in cases involving (check all that apply):*

Protecting freedom of speechSecuring religious libertiesPreserving freedom of associationDefending property rightsReining in the administrative state (defending limited government)Fortifying 2nd Amendment rightsGuarding federalism by ensuring the proper role of the state and national governments under the ConstitutionPreserving separation of powers and protecting against bureaucratic overreachSafeguarding the right to lifeUpholding virtue and morality (e.g. protecting traditional marriage, defending against indecency)Fortifying freedom of contractEnsuring that “All Are Created Equal”
I would NOT like to work on cases involving (check all that apply):

Protecting freedom of speechSecuring religious libertiesPreserving freedom of associationDefending property rightsReining in the administrative state (defending limited government)Fortifying 2nd Amendment rightsGuarding federalism by ensuring the proper role of the state and national governments under the ConstitutionPreserving separation of powers and protecting against bureaucratic overreachSafeguarding the right to lifeUpholding virtue and morality (e.g. protecting traditional marriage, defending against indecency)Fortifying freedom of contractEnsuring that “All Are Created Equal”
DISCLAIMER

Submitting this form does not enroll you with the Center for Constitutional Jurisprudence’s attorney network. You will receive separate notice following the Center’s review of your application. Please be aware that your affiliation with the Center for Constitutional Jurisprudence’s attorney network is at the sole discretion and determination of the Center for Constitutional Jurisprudence and may be denied or terminated for any reason at the sole discretion and determination of the Center for Constitutional Jurisprudence.

Your future involvement with any case undertaken by the Center for Constitutional Jurisprudence will be entirely at your discretion at the time the case assistance request is sent.
I agree to the above disclaimer*

Yes
Should be Empty: