Attorney Application to Receive Referrals of Veteran Criminal Cases

If you would like to join our referral partner list and receive referrals of criminal cases involving veteran defendants, please complete and submit this application. We will advise you if your application is approved and then add you to our list.

Name:
Firm Name:
Address:
City:	State: Select Not USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip:
Email:
Required
Phone:
Website:
Number of full-time staff members:	Years in Practice:
Jurisdiction(s) where you are allowed to practice:	Geographical areas where you will accept cases:
Are you certified as a criminal trial attorney? Select Yes No	How many cases have you tried to verdict?
What types of cases do you want?
What types of cases do you NOT want?
Cases that constitute your “specialty” or the cases you tend to focus on: