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Application for Attorney Case Assignment

  • Use the + and - button to add or remove rows
    NamePreferred contact phone/email 
  • MM slash DD slash YYYY

  • MEMBERSHIP VERIFICATION
    Note: NEA ULSP Guidelines require that individuals must:
    1. Be a member at the time of request for legal services; and
    2. Be a member on the date of the occurrence giving rise to the need for legal services; and
    3. Maintain continuous membership while receiving legal services.
  • Please state each issue separately, and briefly describe the sequence of events for each issue.
  • Provide relevant documents that may help us understand the context of each issue.
    Max. file size: 50 MB.