Application for Specialist Certification


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To apply for certification, complete this application and send it and an application fee of $100 to the Commission at 221 Fourth Avenue North, Suite 300, Nashville, TN 37219. You must complete a separate application, and pay a separate fee, for each certification you seek.

Name: BPR #:
Address:
 
City, State, Zip:
 		 Telephone:
 
  1. 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.

  2. Please attach the following:
    • A copy of the cover page of your malpractice insurance policy showing coverage limits of at least $500,000
    • 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
    • A completed, signed Law Practice Management Checklist (enclosed)
    • A check in the amount of $100, payable to the Commission
    • 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
    • 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:____________________________________