Name:
Firm:
Mailing Address:
City:
State:
Zip Code:
Daytime Phone:
Fax:
Email:
How would you like to be contacted?	email telephone mail
What types of cases are you interested in helping with?	Help with insurance claims for doctor and hospital bills, loss of property, loss of life, etc. Drawing up new wills and other legal papers lost in the flood. Bankruptcy Help with home repair contracts and contractors. Advice on landlord/tenant problems. Advice on eviction or foreclosure problems. Preparing powers of attorney. FEMA Claims (training in this area will be provided as needed) Help with guardianship and other similar legal papers Other (please describe):