Helping Crime Victims Pursue Civil Justice

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Membership Application 

In order to make appropriate referrals to crime victims, it is necessary that we have adequate information concerning each of our members and their practice. Please take a few minutes to answer the following questions.

Login User Account Information
First Name
Last Name
E-Mail (required for Electronic Alerts)
Login (required to access member-only website)
Password
Confirm Password
Agreement I have read and agreed to your terms of service
Contact Information
Firm or Company Name:
Address 1
Apartment/Suite
Address3
City:
Zip/Postal Code
Office Phone:
Fax Number (Optional)
State
HomePhone
Extra Information
Will you see clients after hours?
Will you accept emergency cases?
Will you represent victims to enforce their rights in the criminal justice system?
Please list professional liability and policy limits.
Please list any other states in which you are licensed to practice law.
EXPERIENCE
In What Year Were You First Admitted to The Bar?
How Many Years Have You Been in Private Practice?
What Percentage of Your Practice Involves Civil Litigation?
How Many Years of Experience Do You Have Working with Crime Victims?
What type of crime victims are you interested in representing?
MEMBERSHIPS
Please List Any Other Law-Related Memberships that You Maintain:
CLIENT BILLING PRACTICES
What Is Your Hourly Rate?
What Is Your Usual Contingent Fee Arrangement?

The National Center for Victims of Crime takes the confidentiality of your information very seriously. For this reason, we use the highest level of security that technology provides when dealing with your credit card information. To guard against fraud, your information is securely encrypted and automatically passed directly to the financial network for processing. We do not keep your credit card information on file and at no time does the National Center make this information available to anyone else.

The National Center for Victims of Crime is a 501 (c)(3) not-for-profit organization. Contributions are tax deductible to the extent permitted by law.

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Contacts: 2000 M Street NW, Suite 480, Washington, D.C. 20036 phone: 800-FYI-CALL fax: 202-467-8701, email: victimbar@ncvc.org   
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