CoLA - Colorado Lawyers for the Arts -
 

Request for Legal Assistance: Individuals

Administration Fee: $50.00

 
Please complete this form and click "submit" to return it to Colorado Lawyers for the Arts
Name: County:
Home Address: City/Zip:
Business Address: City/Zip:
Business Name: Best time to call:
Phone: Home/Cell:
Email: Website:
Fax:

IMPORTANT: All notices are going via email. Please update your email address when changed. Thanks.

Please check your artistic discipline(s):

Dance Literary Media: Film/TV/Video/Radio Music Theatre
Visual: Photography/Painting Visual: 3-dimensional

1. Adverse or Other Part(ies) (if any):

Name/Address/Phone# of Adverse Contact Person:

2. Please describe the nature of your art work/activities:

3. Please describe in detail the nature of the issue or problem for which you are applying for assistance:

4. Have you consulted a lawyer regarding this problem? Yes No
If yes, please note who was consulted, and why you are not pursuing the matter with the lawyer consulted:

5. Have you ever used Colorado Lawyers for the Arts (CoLA)before? Yes No
Have you attended any of our activities: Yes No
If yes, which ones?

Educational BOA Brown Bag Social Auction        on:

6. How did you hear about CoLA:
I/We attended an Educational Presentation on:  
CoLA website
A Friend
Other  

7. Funding sources for CoLA frequently ask for names of some of our members. If it is determined that you are eligible for assistance, may we list your name? (Determination of eligibility is in no way affected by your response). Yes No
  • I hearby affirm that the above information is correct, and, to the best of my knowledge, complete.
  • I request that Colorado Lawyers for the Arts (CoLA) refer me to a volunteer attorney.
  • I agree to report immmediately to CoLA any changes in our financial circumstances.
  • I understand that CoLA makes no representation as to the skill of the referred attorney nor as to whether the representation will be successful. I understand I will be represented by the referred attorney or the referred attorney's law firm and not by CoLA. CoLA is merely a referral organization.
  • I understand that a non-refundable administrative referral fee of $50.00 must be mailed to CoLA, in addition to my membership fee, if my membership fee is not current. Furthermore, I understand that the fee covers the referral for this single legal issue only, and any separate or subsequent legal issue requires an additional referral request and fee payment.
  • By submitting this form without a signature, the artist-member agrees to all terms and conditions of the application and understand that use of this Web site does not create an attorney-client relationship between the artist- member and Colorado Lawyers for the Arts (CoLA), its employees, directors, officers or any contributors to this web site. UNDER NO CIRCUMSTANCES SHALL CoLA BE LIABLE FOR ANY DAMAGES, INCLUDING DIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR EXEMPLARY DAMAGES THAT RESULT FROM THE USE OF, OR THE INABILITY TO USE, THIS WEB SITE OR THE INFORMATION GATHERED AND/OR CONTAINED ON THIS WEB SITE, EVEN IF CoLA HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

Signature: Date:

PAYMENTS CAN BE MAILED TO P.O. BOX 48148, DENVER, CO. 80204, WITH PROOF OF FINANCIAL QUALIFICATION (TOP PAGE ONLY OF MOST RECENT TAX RETURN); OR IF THE TAX PAGE IS FAXED, MEMBERS MAY PHONE-IN CREDIT CARD INFORMATION: (303) 722-7994   Fax (303) 778-0203