PRO BONO FORM 3

APPLICATION BY A MEMBER TO REGISTER PRO BONO MATTER

Date of Application
Details of Legal Practitioner
Name
Postal address

Physical address

Phone number
Email address
Signature
Details of Client
Name of Client
Postal Address

Permanent Address
(Village, T/A, District)
Residential Address
Phone number
Other contacts
Attachments (Summary of
dispute and other
documents if available)
Nature of dispute
Case Details if registered
in court
Reasons why client
requires legal aid

For Official Use Only

Date Application
Received
Name of Receiving
Officer
Signature of Receiving
Officer
Date Application
Approved
File Number (if approved) MLS/PB/
Reasons for not approving
application
Name of Approving
Officer
Signature of Approving
Officer