Wise4Afrika Legal Assistance Intake Form
Please use this form to request legal assistance from The Wise Collective. You must answer all required questions/statements in order to receive representation. Please note that we have limited resources and our services require full cooperation from those requesting them. We also require at least 10 working days lead time on pre-scheduled court dates unless it's an urgent application.
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Email *
Full Name *
Mobile Telephone *
Residential Address *
Brief history of case *
Name of Jurisdiction (police station where case opened, court where matter is scheduled, etc.) *
Case number and name of detective/prosector if available *
Upcoming court appearance or any other pending intervention deadline *
Are you compliant with all court orders related to the case? *
Do you have supporting documents such as court orders, copy of protection order, etc., related to your case? *
Are you able to contribute towards your legal fees, if so, how much? *
If my case is selected for representation, depending on merit of the case and capacity of the team, I commit to cooperating with representing counsel, including but not limited to, providing all requested information within a timely manner, honoring all appointments including court appearances, etc., Failure to show up in court will be grounds for counsel dropping the case. In addition I consent to general aspects, without personal identifying information, being used for reporting and marketing purposes including in advocacy campaigns. *
A copy of your responses will be emailed to the address you provided.
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