Client Application
The Innovate Capital Business Law Clinic (the "Clinic") is an educational program of Campbell Law School. In the Clinic, student-attorneys represent companies that would not otherwise be able to afford legal services on a variety of matters. Applicants are not guaranteed services even if they are eligible. Whether the Clinic can accept any particular potential client depends on a number of factors, including not only client eligibility but also the clinic’s current workload, conflicts and other professional responsibility considerations, and our assessment of the fit between the legal services we provide and the needs of the potential client.  All student attorney representation is provided under the supervision of the Clinic Co-Directors or another fully licensed attorney.  Please review our website for more information.  

APPLICATIONS RECEIVED AFTER JANUARY 9 2021 WILL AUTOMATICALLY BE PLACED ON OUR WAIT LIST AS WE HAVE MADE OUR INITIAL SELECTION OF CLIENTS FOR THIS SEMESTER.

PLEASE DO NOT PROVIDE ANY CONFIDENTIAL INFORMATION WHEN RESPONDING TO THESE QUESTIONS.
Please respond to all questions below (unless indicated as optional).  Replies of "N/A" or "Not known" are acceptable.
Sign in to Google to save your progress. Learn more
Email *
*
What is your name (First and Last)? *
What is your Phone Number *
Are you seeking legal counsel on behalf of: *
What is the (actual or proposed) name of your company? *
Where is your business located?   *
Have you formed a company?   *
If you have formed a company, who assisted you with formation? (Please provide name of any lawyer, law firm, accountant, accounting firm, on-line service provider (like LegalZoom), etc.  If you have not formed your entity please answer "not applicable" *
If you have formed a company, in what state is it organized? *
If you have formed a company, it is a: *
If you have formed a company, have you made an S-Corp election?   *
What is your title or relationship to the venture? *
The Clinic is a pro-bono clinic, and as such, we seek to provide legal and business assistance to those entrepreneurs and companies that cannot otherwise afford private representation.   Please respond below and to the following questions designed to help us assess your eligibility. *
Please briefly describe your financial circumstances in the space provided below: *
Does your company have any assets (cash or otherwise)? *
Does your business have any revenue? *
Does your business have any marketable products at this time? *
Have you or has your business raised any capital?  (Mark all that apply) *
Required
Briefly describe your product(s) and/or service(s) *
Why do you think this has commercial value?  What makes it important and different? *
What past experience do you (or members of your team) have that can help you make this business a success? *
How do you define what success is for this business? *
What are the missing pieces to making this business successful? *
Do you have a written business plan or slide deck? *
Please list the names of all the founders/owners of the company, or all the individuals who have (or will claim) ownership once a company is formed.   *
Is your company represented by legal counsel for any other matters or have you ever engaged in legal counsel for your company? *
Please list the names of any members of the Board of Directors or Managers of the company: *
Does your company have accounting, bookkeeping and/or tax advisors? *
Please list the names and titles of any officers of the company: *
Please list the names and titles of any persons or individuals that may be in an “adverse” position with respect to the company or the subject matter of the representation. By "adverse" we mean counter parties you might have us negotiate an agreement with, etc. *
Is there anything else you think it is important that we know about your business? *
Please describe the legal and business issues you currently would like assistance on *
During each semester the clinic will focus on several “Featured Clinic Topics”.  Please check the box next to the topic(s) you would like assistance with.   *
Required
Do your legal needs have any upcoming firm deadlines?   If so, please explain. *
What is your Address? *
Are you affiliated with Raleigh Founded?   *
Are you affiliated with Campbell University? Please mark all that apply *
Required
If you are you a student, faculty member or otherwise affiliated with another university, please identify the nature of your affiliation   *
Required
Has any team member used the Clinic's services before, or been a member of a venture that is or was a clinic client? *
Has anyone from your venture been employed by or affiliated with any employer or academic research program that relates to the venture or technology in question?   *
If you are part of any accelerator or similar programs, please identify *
How did you hear about the Clinic? *
Required
The Clinic is a training ground for future lawyers.  The Clinic includes in it’s acceptance criteria the willingness of Clients to contribute the quality of the student lawyer’s education experience.  Please indicate whether you are willing to do any of the following beyond what is required for students to prepare documents for you.  Mark all that apply *
Required
Please check below to confirm that: (a) All of the information submitted is accurate to the best of your knowledge, (b) This interaction does not establish an attorney-client relationship. You may seek another legal resource, you may not qualify for representation, or the Clinic may decline to undertake representation for any reason. Any attorney-client relationship, if any, will be formed only via a countersigned engagement letter after further discussion. (c) Because the Clinic is staffed by law students, the sufficiency of Clinic resources to meet immediate deadlines or time-sensitive matters is constrained by the availability of students, which is seasonal and dependent on the academic calendar, and therefore the Clinic may be unable, or may decline, to take on your matter if it is time-sensitive. If appropriate, the Clinic may refer you to outside counsel. *
Required
Please confirm whether you would like to be placed on our waitlist if we are not able to undertake representation at this time. *
We can often make referrals to other legal counsel for matters outside our expertise and/or business counseling assistance.  We cannot guarantee these services will be made available on a pro bono or no-cost basis.  Please confirm whether we can share the information you have provided to us with these outside parties. *
Required
IMPORTANT INFORMATION ABOUT OUR CO-DIRECTORS: The Co-Directors of the Business Law Clinic are also the Co-Founders and owners of Innovate Capital Law, a for-profit law firm.  Since the Co-Directors are in private practice outside of the Clinic, there may be a financial incentive for the Co-Directors to steer applicants and clients of the Clinic to their firm for private representation.  The Co-Directors do not believe that this relationship will impair the Clinic’s representation of you or their ability to supervise Student Attorneys.  Further, should private representation be appropriate or necessary for you, you have the right to counsel of your choice and the Co-Directors and Clinic will endeavor to provide you with enough information to make an informed decision.  You have many options in the choice of legal counsel should you need to obtain one outside of the  Clinic.  You are not required to engage Innovate Capital Law nor will it be the appropriate or acceptable choice in all circumstances.  We will endeavor to provide you with advice about the representation alternatives should such circumstances arise. *
Required
Please specify your ethnicity. (OPTIONAL)
Clear selection
What are your preferred pronouns? (OPTIONAL)
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Campbell University. Report Abuse
Google Forms