Pro Bono.

Apache Legal PLLC - Pro Bono Client Intake Questionnaire

Thank you for your interest in Apache Legal PLLC’s pro bono legal services. We are committed to providing high-quality legal assistance to individuals and organizations in need. To determine eligibility for our pro bono services, please complete the following intake questionnaire. All information provided will be kept confidential.

Full Name *

Date of Birth *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Phone Number *

Email Address *

Preferred Contact Method *PhoneEmail

Are you a U.S. citizen or lawful resident? *YesNo

8.Do you require an interpreter? If yes, what language?

Marital Status *

Number of Dependents *

Current Employment Status *

Employer

Monthly Household Income *

Sources of Income (e.g., Wages, Social Security, Disability, Public Assistance, Child Support, etc.) *

Total Household Assets (Including savings, investments, real estate, etc.) *

Outstanding Debts (Include mortgages, loans, credit card debt, etc.)

Are you currently receiving legal aid from any other organization? *YesNo

Briefly describe the legal issue you are facing *

What type of legal assistance are you seeking? (Check all that apply) *

Have you previously consulted an attorney about this matter? *YesNo

If yes, what was the outcome?

Are there any impending deadlines or court dates related to your legal issue? *YesNo

If yes, please provide details

Are there any documents relevant to your case that you can provide? *YesNo

Why do you believe you qualify for pro bono legal assistance? *

How would receiving legal assistance from Apache Legal impact your situation? *

Have you applied for pro bono services with another organization? *YesNo

28.If yes, what was the outcome?

Certification & Acknowledgment *

By hitting submit, you certify that the information provided in this intake questionnaire is accurate and complete to the best of your knowledge. You also certify that you understand that submission of this form does not guarantee legal representation and that Apache Legal PLLC reserves the right to determine eligibility for pro bono services based on its criteria and case priorities.

Pro Bono