OFFICE OF THE FEDERAL PUBLIC DEFENDER

EASTERN DISTRICT OF VIRGINIA

1650 King Street

Suite 500

Washington, D.C. 22314

FAX: 703-600-0880

APPLICATION FOR ASSISTANT FEDERAL PUBLIC DEFENDER (AFPD) POSITION

ALEXANDRIA DIVISION

NOTE: If you require more space for your answers than is provided following the question, please use additional sheets, identifying the question number, and attach the supplemental sheets to the end of the application.

GENERAL:

1. Name______2. SSN: ______

3.Office Address:______Office #:______

______

4.Residential Address: ______Home #:______

______Cell #:______

5.e-mail address(s): ______

6.Are you a U.S. citizen? Yes ____ No ____

7.Military service:

Service / Branch / Dates

Rank or rate at discharge:

Type of discharge:

If still a reserve or National Guard member, please give service, branch, unit and present rank: ______

8.(a) Are you related by blood or marriage to any members of the federal judiciary?

Yes No ____

(b) If yes, give their names, district or circuit, and your relationship to them:

EDUCATION:

9.List the colleges, universities, and law schools attended, and the dates and degrees earned, and approximate class ranking (by percentage or quartile):

College/University / Dates Attended / Degree Received / Class Ranking

HONORS:

10.List your law school honors (e.g. law review, class standing or other academic professional achievements, etc.):

11.List the five most recent legal education courses or seminars attended, including sponsors and approximate dates:

EMPLOYMENT HISTORY:

12.Please provide the names of all law firms, government agencies and/or private business organizations in which you have been employed on a full-time, part-time & volunteer basis:

Organization / City/State / Dates of Employment

13.Briefly describe the general nature of your current practice, including any legal specialties which you possess:

BAR ADMISSIONS:

14.List all states and courts the bars to which you are admitted. Also list any administrative bodies having special admission requirements before which you are presently admitted to practice, giving the dates of admission in each case:

Court or administrative bodyDate of admission

______

______

______

______

______

LITIGATION & RESEARCH EXPERIENCE:

15.(a) Do you regularly appear in court?

(b)For each of the below, over the past five years, how often have you appeared in court (e.g., weekly, at least once a month, or couple times a year):

Federal district courts

Federal appellate courts

State trial courts

State appellate courts

Juvenile court

Administrative bodies

Which administrative bodies?

16.(a) During the last five years, what percentage of your practice has involved:

trial practice ______; appellate practice ______; other ______, please explain

______

(b) What percentage of your practice involving litigation has been in

civil ______criminal ______

(c) What percentage of your practice has been in

federal court ______state court ______

17.For the past three years, if practicable, please list the cases that you have tried to conclusion in courts of record. For each one, indicate the case name; the name of the court and the dates of trial.

Case Name / Court / Date(s)

18.For the past five years if practicable, please list the cases that you appealed. For each one, indicate the name of the case; the name of the court; and the date of decision.

Case Name / Court / Date

19.Summarize your courtroom experience prior to the last five years:

20.State the case name, docket number, court, judge, and names and addresses of adversary counsel in the three most legally significant cases you have had in the last five years:

21.Name each federal district judge in the Eastern District of Virginia before whom you have appeared:

PRIOR JUDICIAL EXPERIENCE:

22.(a) Have you ever held judicial office or been a candidate for judicial office?

Yes No

(b) If so, please state the courts involved and the dates of service, or dates of candidacy:

(c) Prior quasi-judicial service:

Name of agency:

Position held:

Hearing on what issues:

Number of cases adjudicated:

Dates of service:

PROFESSIONAL AND OTHER ACTIVITIES:

23.(a) List all bar associations and legal professional societies of which you are a member, and give the titles and dates of any offices you have held in such group and/or committees to which you belonged:

(b) List all other organizations and clubs of which you have been a member during the past ten years, including the titles and dates of any office you have held in such organizations:

OTHER BUSINESS ACTIVITIES:

24.(a) If you are now an officer, director or otherwise engaged in the management of any business enterprise, state the name of such enterprise, the nature of the business, the nature of your duties, and whether you intend to resign such position immediately upon appointment:

(b) Since being admitted to the bar, have you ever engaged in any occupation, business or profession other than the practice of law? Yes No ____

(c) If yes, please explain (include dates):

25.(a) Have you ever been sued by a client? Yes No ____

If yes, please explain:

(b) Have you or your professional liability insurance carrier ever settled a claim against you for professional malpractice? Yes No ____

If yes, please explain (include amounts involved):

26.Have you ever been disciplined or cited for a breach of ethics or unprofessional conduct by any court, administrative agency, bar association, or other professional group?

Yes No ____

If yes, please explain:

27.Have you filed appropriate tax returns as required by federal, state, local and other government authorities? Yes No ____

If no, please explain:

28.Does the Internal Revenue Service have any liens or claims outstanding against you?

Yes No ____

If yes, please explain:

29.Have you ever been charged in any civil or criminal proceeding with conduct alleged to involve moral turpitude, dishonesty and/or unethical conduct? Yes No ____

If yes, please explain (include full name of case):

30.Have you ever been arrested, charged or convicted for violation of any federal law, state law, county or municipal law, regulation or ordinance? (Do not include traffic violations for which a fine of $150 or less was imposed unless it also included a jail sentence; do include DUIs and DWIs even if fine of $150 or less imposed.) Yes No ____

If yes, please explain:

SUPPLEMENTAL INFORMATION:

31.Please provide any other pertinent information which may reflect positively or adversely on you, or which you believe should be disclosed in connection with your possible selection as an AFPD:

32.List the proficiency of your skills and capabilities in the following areas:

Command of languages other than English: ______

Computer skills:

Power Point: ______

Word processing: ______

Database management of exhibits:______

Other: ______

39.Are you able to conduct all of your own computerized legal research on either Westlaw or Lexis-Nexis without assistance from others? Yes No

40.Are you able to generate your own correspondence and pleadings without assistance from others such as a secretary or a paralegal? Yes No

41.Describe any experience you have in death penalty cases:

42.List as references five individuals who are familiar with your abilities and character:

NameContact Telephone Number

43. Please provide a written statement explaining why you wish to work for the Office of the Federal Public Defender.

APPLICANT CERTIFICATION

I certify that, to the best of my knowledge and belief, all of the information on and attached to this application is true, correct, complete and made in good faith. I understand that false or fraudulent information on or attached to this application may be grounds for not hiring me, or terminating my employment after I begin, and may be punishable by fine or imprisonment. I understand that any information I give may be investigated.

______

Signature Date