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Intake Eligibility Form

Please fill out all applicable fields below.

    First name:
    Email:
    Birth date:


    Address line 1:

    Address line 2:

    City:
    State:
    Zip code:


    Brief description of legal problem:

    Full name of adverse opposing party:

    Domestic violence victim?

    Monthly household income:

    Number of people living in home:

    I am: WhiteBlackHispanicNative AmericanAsianUndeclaredOther:

    “I choose to allow Pro Bono Project to release my general information to the below checked organizations for the sole purpose of legal referrals within Mesa County.”
    Colorado Legal Service (CLS)Latimer HouseHilltop ServicesLocal AttorneysSelf Help Center/Family Court FacilitatorOther:

     

     

    Attorney Sign-Up Form

    Please fill out the info below and we’ll contact you!

      First name:
      Email:


      Address line 1:

      Address line 2:

      City:
      State:
      Zip code:


      I am willing to volunteer in these areas of law:
      Family LawProtection Orders/Domestic ViolenceLandlord Tenant/Warranty of HabitabilityBankruptcyElder LawCollectionTeaching Legal ClinicsOther:

      Additional comments: