AMERICAN BAR ASSOCIATION
TORT TRIAL INSURANCE PRACTICE SECTION
TIPS LEADERSHIP ACADEMY
Please fill in blanks and return to TIPS Administrative Assistant, Theresa Beckom by mail, email or fax byMarch 21, 2016.
Mail to: American Bar Association, Tort Trial & Insurance Practice Section, 321 N. Clark Street, Chicago, IL 60654-7598
Email:
Fax: 312-988-6230
Phone: 312-988-5607
Full Name:
Phone:
Firm/Org:Fax:
Mailing Address:Email:
City:State:Zip:
Type/Area of
Practice:LawSchool:
Years in Practice:
Date & State of License:
PLEASE SUBMIT A PHOTOGRAPH WITH THE APPLICATION.
Participants are expected to attend each of the TIPS meetings in their entirety during the 2014-15 bar year.
October 12 – 16, 2016TIPS Fall Leadership Meeting
February 2 – 5, 2017ABA Midyear Meeting
April 26 – 30, 2017TIPS Section Spring CLE Conference
August 10 – 13, 2017ABA Annual Meeting
Are you willing and able to make a commitment to attend all meetings? YES NO
Do you have the full support of your colleagues/employer for YES NO
the required participation commitment?
(1) Please list leadership roles you hold or have held in the legal profession:
(2) Please list leadership roles you hold or have held outside the legal profession:
(3) Please list your experience with the ABA and TIPS—Committee involvement,Leadership roles, etc.
(4) List any additional information you would like to have considered when your application is
reviewed, i.e. memberships, honors, training, education, life experience:
(5) Here is a list of TIPS general committees. Please indicate which committees reflect your professional expertise.
___Admiralty and Maritime Law
___Animal Law
___Appellate Advocacy
___Automobile Litigation
___Aviation and Space Law
___Business Litigation
___Commercial Transportation Litigation
___Corporate Counsel
___Dispute Resolution
___Employee Benefits
___Employment and Labor Law
___Excess Surplus Lines and Reinsurance
___Fidelity and Surety Law
___Government Law
___Health and Disability Insurance Law
___Insurance Coverage Litigation
___Insurance Regulation
___Intellectual Property Law
___International
___Life Insurance Law
___Media Privacy and Advertising Law
___Medicine and Law
___Products Liability
___Professionals’ Officers’ and Directors’ Liability
___Property Insurance Law
___Self-Insurers and Risk Managers
___Staff Counsel
___Title Insurance Litigation
___Toxic Torts and Environmental Law
___Trial Techniques
___Workers’ Compensation and Employers’ Liability Law
(6) List two persons with knowledge of your attributes by full name, address, phone number
and e-mail address:
Name:Name:
Address:Address:
City/State/Zip:City/State/Zip:
Phone: ( )Phone: ( )
Email:Email:
(7) Identify three important issues facing the legal profession:
1.
2.
3.
(8) Describe why you are interested in participating in this leadership program and what you expect to gain from the experience. You may wish to include your concept of leadership and the skills and attributes of a leader.
Attach additional pages if necessary
Please attach a photo
Signature: Date: