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Tennessee Commission on CLE and
Specialization
221 Fourth Avenue North
Suite 300
Nashville, TN 37219
| Name: |
BPR #: |
Address:
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City, State, Zip:
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Telephone: |
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Please check the certification you seek and
attach confirmation of your corresponding certification from ABBC, ABPLA, CLLA,
NBTA, or NELF.
| _____ Accounting Malpractice
Specialist |
_____ Elder Law Specialist |
| _____ Business Bankruptcy
Specialist |
_____ Estate Planning Specialist |
| _____ Civil Trial Specialist |
_____ Family Law Specialist |
| _____ Consumer Bankruptcy
Specialist |
_____ Juvenile Law - Child
Welfare |
| _____ Creditors Rights
Specialist |
_____
Legal Malpractice Specialist |
| _____ Criminal Trial Specialist |
_____
Medical Malpractice Specialist |
| _____ DUI Defense Specialist |
_____ Social Security Disability
Spec. |
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Please attach the following:
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A copy of the cover page of your malpractice
insurance policy showing coverage limits of at least $500,000
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A list of the names and addresses of five
clients you have represented during the past three years in the area in which
you are seeking certification. If you were a judge or employed by a
governmental agency or corporation during the past three years, please contact
the Commission
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A completed, signed
Law Practice Management Checklist (enclosed)
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A check in the amount of $100, payable to the
Commission
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A copy of all advertisements currently
running on your behalf or on behalf of any firm in which you are a partner,
associate, or of counsel
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A copy of any order holding you in contempt
of any court or administrative agency, or assessing sanctions of any type
against you for actions in any judicial or administrative agency.
Pursuant to DR 2-101(C), it is an
ethical violation to advertise a certification you do not have, or to advertise
any certification until you are certified by this Commission. If an
advertisement appears claiming your certification from this Commission, or any
other certification, before you are certified by this Commission, this
Commission will put your application on hold and notify the Board of
Professional Responsibility of an ethics violation and the Tennessee Division
of Consumer Affairs of a Consumer Protection Act violation. Your signature
below indicates that you have read this Disclosure, have reviewed DR 2-101(C),
and that you believe all of your advertising is in compliance herewith.
In addition to Tennessee I am licensed in:________________________________
I hereby release the Board of Professional Responsibility of the Supreme Court
of Tennessee, and the disciplinary agency of any other state in which I have
been or am licensed to practice, to provide to the Commission information on
all disciplinary complaints ever filed against me, including those
administratively dismissed by the Board or any other agency, or resulting in
non-public discipline. I further release the Commission and any organization
certifying me as a specialist in the areas listed above to disclose and discuss
any information obtained as part of my application to either the Commission or
the organization.
Date:_______________________
Applicant's signature:____________________________________
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