AMAN WELFARE AND LEGAL AID FOUNDATION

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FIELD OF WORK :-

FREE LEGAL AID FOR THE POOR SECTION
SPECIAL CELL FOR SCs AND STs
HUMAN RIGHTS VIOLATIONS
LEGAL AWARENESS PROGRAMME
WELFARE PROGRAMMES

Download Form

APPLICATION FOR EMPANELMENT AS LEGAL AID COUNSEL

Applicant’s Name :*

Father’s / Husband’s Name :*

Date of Birth : *

Age (as on 30.11. 2023) :*

Gender : *

Residential Address : *

Educational Qualifications :*

Course

Name of Board/University

Year of Passing

Pass% (Aggregate)

Intermediate

Professional Degree
(LLB)/
(B.A.LL.B)

Post Graduation (LL.M)

Chamber Address :*

Telephone No. (R): *

Mobile No : *

Fax No : *

E-mail : *

Date of Enrolment as an Advocate: *

Enrolment No.: *

Practice Experience (Duration of actual practice for which applied): *

(a) Total No. of cases handled: *

(b) Nature of cases handled: *

Specify whether earlier remained on the panel of the Company or any other Institution/Government Department (please tick in the concerned column): *

Yes No

Whether any disciplinary case/complaint was against the applicant with any Bar Council/JHALSA? *

Yes No

DECLARATION:

I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. In the event of any information being found false /incorrect at any stage, my candidature is liable to be cancelled. I have read and understood the instructions and terms and conditions of the empanelment and agree to abide by those. I declare that I fulfill the eligibility conditions for the category to which I am seeking empanelment. I have not submitted any other application for empanelment, besides the present one.

Place: *

Date: *

Upload your signature (PDF/JPEG): *
Upload your Photograph (PDF/JPEG): *
Upload your enrolment certificate PDF/JPEG: *