UNITED STATES DISTRICT COURT
C ENTRAL D ISTRICT OF C ALIFORNIA
APPLICATION FOR MERIT SELECTION PANEL
ATTORNEY MEMBER
Provide the following information sequentially on plain, letter-sized paper. Each
request or question and your response should be typed and single-spaced. Please
send your completed application no later than the deadline set forth on the Court’s
website to:
[email protected].
1. Name:
2. Business Address (Include firm name, phone and fax numbers & email address):
3. Home Address:
4. State Bar Number:
5. Describe with specificity the nature and length of time of your practice, including
areas of emphasis and specialization certified by the State Bar of California.
6. What percentage of your practice involves litigation in federal court?
7. What percentage of your practice involves litigation in state court?
8. List ten significant litigated federal cases by name, docket number and judge and
indicate whether you were sole, lead or associate counsel.
9. Have you ever served as a member of the Merit Selection Panel? If so, list the
dates of your service.
10. Have you served on any other judicial selection committees? If so, list the
committee and the dates of your service.
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UNITED STATES DISTRICT COURT
C ENTRAL D ISTRICT OF C ALIFORNIA
11. List all bar associations and legal professional societies in which you are or have
been a member and give the titles and dates of any offices you have held and
committees on which you served during the past ten years.
12. Are you now or have you ever served as a lawyer representative in any district
court? If so, list the court and the titles and dates of any offices you have held.
13. If you have been appointed as a lawyer representative, are you now or have you
previously served on a Ninth Circuit Committee or Board? If so, list the
committee or the board and the dates of your service.
14. Have you ever been disciplined or cited for a breach of ethics or unprofessional
conduct by, or been the subject of a complaint to any court, administrative agency,
bar association, disciplinary committee or other professional group? If so, provide
the particulars, including the applicable dates and disposition. (Identify every
complaint even if it was dismissed or did not result in disciplinary action.)
15. Have you, to your knowledge, ever been under federal, state or local investigation
for a possible violation of a criminal statute? If so, provide the particulars.
16. Please state why you wish to serve on the Merit Selection Panel and what you can
contribute that makes you a good candidate for appointment.
17. Describe any additional background you would like to share that is relevant to
your appointment to the Merit Selection Panel, including but not limited to how
you can contribute to the diversity and broad composition of the Merit Selection
Panel.
18. List three professional references that can attest to your qualifications to serve as a
member of the Merit Selection Panel. (Include name, title and contact
information.)
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UNITED STATES DISTRICT COURT
C ENTRAL D ISTRICT OF C ALIFORNIA
I declare under the penalty of perjury under the laws of the State of California and the
United States that the answers and statements provided by me in this application are true
and correct.
Name: ________________________ Signature: ________________________________
(Type or Print)
Executed at: on _____________________
Attachment: Resume
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