This nonprofit template includes 9 fields. Screen low-income individuals for eligibility for free pro bono legal assistance. Free to customize and use on ZenBuild.
Full Name (text, required)
Phone Number (text, required)
Email (if available) (email, optional)
Legal Issue Type (dropdown selection, required) — options: Family Law, Housing/Eviction, Immigration, Employment, Criminal Record Expungement, Consumer Debt, Other
Monthly Household Income ($) (number, required)
Household Size (number, required)
Brief Description of Legal Situation (long text, required)
Is There an Upcoming Court Date? (multiple choice, required) — options: Yes, No, Unknown
