Salutation
Mr.
Mrs.
Dr.
Hon.
Ms.
Nickname (will appear on nametag)
First Name
Last Name
Email
Phone
Company
Mailing Address (No P.O Boxes)
City
State
Select
AL
AK
AZ
AR
CA
CO
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DE
DC
FL
GA
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KS
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OH
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OR
PA
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WA
WV
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Zip
Are you responsible for making professional training decisions for your firm?
Yes
No
If no, please provide the name and contact of the person who is responsible
Preferred Program Dates
Training Site Description
We are requesting an advocacy training program that is specifically tailored for attorneys or advocates who serve indigent or disadvantaged populations, including legal aid, child advocacy, tribal court, criminal law, and domestic violence, AND
The participants are lawyers from a public agency doing work in these areas, OR
The participants are lawyers in private practice who work in these areas and devote at least 50% of their practice to providing legal services for clients who are indigent and unable to secure fee-based legal representation.
Please provide a brief description of the reason for your training program and the reasons you are seeking NITA Public Service program pricing. (Email additional documentation to customerservice@nita.org if applicable)
Program Requested
Trial
Deposition
Child Advocacy
Other
Other (please specify)
Number of participants to be trained
24
32
40
48+
Will you be charging an attendance fee?
Yes
No
Public Service Can You Provide Food/Beverage
Yes
No
How many hours can your attorneys commit to a NITA training?
Are you interested in an
In-person training
Online training
Either
Does your organization have a professional training budget?
Yes
No
What is your organizations estimated revenue for this year?
How much money has your organization allocated to funding this training?
Federal Grant
Yes
No
Does funding expire?
Yes
No
If yes, when do funds expire?
Are funds restricted in any way?
Yes
No
If yes, please describe
Public Service Describe Participants Trained
LSC funded
Court Improvement Program funded
Public Agency
Private not-for-profit agency
Private pro bono panel
Tribal funded
Other
Other, please describe
What criteria do you use to select attorneys to participate in this course?
Do you have attorneys/advocates who can serve as co-teachers alongside NITA faculty?
Yes
No
Is everyone attending a participating attorney?
Yes
No
If no, please describe who will be participating
Will your organization be partnering with any other organizations for this training?
Yes
No
If so, please indicate who
Would you be willing/interested in partnering with another public interest organization?
Yes
No
If you are interested in partnering with another public interest organization would you have facility space to accommodate the program?
Yes
No
I have read the NITA cancellation policy as well as the responsibilities as a program host. I agree and understand the terms and conditions
Cancellation Policy
(click to review policy)
I further agree that each individual who is registered for this course will complete the duration of the course.
Yes
Privacy Policy
Privacy Policy
(click to review policy)
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