Registration Form

Please fully complete and submit this form.  This form is only an application. You must receive confirmation to ensure there are still spaces available.  If you do not receive a response within one week, please email ekreitzberg@scu.edu.  Send check separately.

Additional information

• Use of Registration Form/Fact Sheet: This form will be used in workshop exercises with other DPC student participants and faculty members. Please keep that in mind when completing this form and make every effort to provide your colleagues with information that will assist them to work with you on your case. The more thoughtful the information provided, the more useful for your workshops.

   

• Once complete with registration, please print and sign the confidentiality pledge

   

First Name :
Last Name :
Gender :	--MaleFemale
State Bar ID :
Employer/Institution :
Address :
City :
State :	--AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY
ZipCode :
Email Address :
Day Phone :
Fax :
Defendant's name :
Next court date and type of hearing :
Type Of Case :	--StateFederalMilitary
Describe the location of the crime:
Co-Counsel :
Mitigation specialist (name) :
Investigator (name) :
Expert(s) hired (name, office location and area of expertise) :
Describe your relationship with your client :
Who on your team has the best relationship with your client and why :
Defendant's gender race and age :
Any mental health issues for your client :
Have there been any mental health evaluations conducted by you for the government: (if yes, describe):
Any issues of MR for your client :
Any information on childhood abuse or trauma :
What are significant facts about your client's life :
Who in your client's family has the best relationship with your client and why :
Describe the kind of voir dire you expect to get in your case:
Victim gender, race and age :
Victim relationship to defendant :
Co-Defendant(s) (name) :
Co-Defendant counsel(s) (name) :
Special circumstances alleged (Death eligibility criteria):
Brief statement of facts of case (Re: guilt):
Brief statement of facts in support of special circumstances or death eligibility criteria:
What would you call the "killer" facts in your case?:
What are the "life" facts?:
What do you know about your clients life and family:
What do you know about the mental health issues of your client:
Facts in mitigation for your client:
Facts in aggravation against your client:
Describe the victim impact evidence in your case:
Describe your client's institutional adjustment:
Your theory of the case - Re: penalty
What are the major obstacles for settlement in this case?
Has there been a plea offer. If so, what happened?
What is your client's biggest fear or greatest concern?
Any other unique facts or aspects about your case (Please specify aspects of your state statute that may be an issue in the case and cite to that portion of the statute):
Dorm Room :	enter yes or no
Suite mate request :
Any Special Dietary Needs :
Date Admitted to the Bar :
Please indicate which of these work documents you maintain:
	Social History Chronology Family Tree Records Request Log Players List (Potential Witness List)
Do you have a team for your capital trial? :	--YesNo
Who are all of the persons on the team and what are their roles?
Is there a team leader :	--YesNo
Who is that person and why?
How does the team decide when to meet?
How often does the team meet?
Has the team had any major disagreements?
Can you describe?
How does the team resolve disagreements?
How does the team handle communication with the client?
How often is the client visited and by whom?
Who is putting together the social history?
How is the social history being documented?
Homicide Trials :
Capital Case Experience :
Penalty Phase Trials :
Penalty Cases tried to verdict :
Number of life without parole sentences :
Number of death sentences :
Please enter the text you see below: