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First and Last Name*
City, State, Zip*
Direct Telephone Number*
Does your firm have a Pro Bono Coordinator?
If yes, please provide contact information.
First and Last Name
Direct Telephone Number
Are you registered and in good standing to practice before the USPTO as a Patent Attorney?*
In what states are you licensed to practice?
State Bar Number
State Bar Admission Date
In which areas of patent prosecution are you willing to provide pro bono services?* Check all that apply.
If other, please specify.
When would you be able to start reviewing pro bono referrals?
Are you willing to advise applicants from filing a non-provisional application through notice of final office action?*
Will your pro bono work representing clients in patent matters be covered at all times by a malpractice insurance policy?
What language(s) do you speak fluently?
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