Columbus Bar Association
Minority Clerkship Program
2XXX Application
Return this application to:
Annette Hudson
Diversity Director
Columbus Bar Association
175 South Third Street, 11th Floor
Columbus, Ohio 43215
614-221-4112
[email protected]
APPLICATION IS DUE TO THE BAR ASSOCIATION NO LATER THAN
Monday, JANUARY 9, 2XXX at 5:00 p.m.
Applications must be submitted IN FULL by the above date and time. Approved submission methods include electronic mail.
CHECKLIST:
____
Application
____
Part C/Addendum A: Resume
____
Part F/Addendum B: Career Goals Statement
____
Part I/Addendum C: Recommendation Form
____
Part J/Addendum D: Additional Disclosures (if applicable)
APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
PART A:
1.
General Information
Name: _______________________________________________________________ Select One: ______ Ms. ______ Mr.
Last
First
Middle Initial
Mailing Address:
_________________________________________________________________
Number
Street
_________________________________________________________________
City or Post Office
State
Zip Code
Permanent Address:
_________________________________________________________________
Number
Street
_________________________________________________________________
City or Post Office
State
Zip Code
E-Mail Address:
_________________________________________________________________
2.
Telephone Number:
(______)__________________
3.
Are you a citizen of the United States?
(Answering no does not automatically disqualify an applicant.)
_____Yes _____No
4.
If no, do you have a permanent visa to work in the United States?
_____Yes _____No
5.
Law School: _______________________________________ Anticipated Graduation Date _________________
Class:
______ First Year _____ Second Year ______Third Year ______Fourth Year
If Capital student, please specify:
_____
Day
_____
Evening
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APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
PART B:
Education
Undergraduate Degree
Other Advanced Degree
1.
College/ University
_______________________________
________________________________
2.
Dates of Attendance
(Month & Year)
_______________________________
________________________________
3.
Concentration / Major
_______________________________
________________________________
4.
Type of Degree
_______________________________
________________________________
5.
Date Received / Expected _______________________________
________________________________
PART C:
Work Experience
1. Current:
__________________________________________________________________________________
Title
Start Date
__________________________________________________________________________________
Organization & Street Address
Telephone
2. Previous:
__________________________________________________________________________________
Title
Start Date
End Date
__________________________________________________________________________________
Organization & Street Address
3. Previous:
__________________________________________________________________________________
Title
Start Date
End Date
__________________________________________________________________________________
Organization & Street Address
Please submit an updated resume labeled as Addendum A with this application.
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APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
PART D:
1.
Additional Training / Experience
Please list any honors and awards for civic, academic, or government work.
Attach additional sheet if necessary.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
2.
Please list and describe any additional training / experience relevant to the Minority Clerkship Program.
Attach additional sheet if necessary.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
PART E:
1.
Writing Skills
Please list all classes, seminars, or work experience that contributed to the development of your writing skills,
analytical skills and research skills. Attach additional sheet if necessary.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
PART F:
Career Goals Statement
Discuss the factors leading to your selection of the Minority Clerkship Program as a means of furthering your personal and
professional development. Be very specific in describing how your participation in this program will enable you to build upon your
prior experiences and achieve your goals. Not to exceed 500 words, typed and double-spaced. (Label as Addendum B)
PART G:
Writing Sample
You are required to complete a legal writing sample at the Columbus Bar Association. You will receive additional information via email. This writing sample is required to be considered for participation in the Minority Clerkship Program.
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APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
PART H:
Employer Selection
Participating employers appear below in their respective sectors, private and public. Please take the time to thoroughly research these
organizations before making your selection. Remember, you are only indicating your preference for interview scheduling by
employers. In an effort to ensure each applicant receives a greater opportunity for summer employment, the Minority Clerkship
Program reserves the right to schedule an interview with an employer an applicant has not selected.
If you are interested in ONLY public sector employment, please skip this section and proceed to the Public Sector below.
Private Sector:
I am interested in being considered by up to 6 of the following private sector employers:
Bailey Cavalieri LLC
(1L only) ________
7-10 weeks
Baker & Hostetler LLP
(1L only) ________
6 weeks
Bricker & Eckler LLP
(1L only) ________
7-10 weeks
Calfee, Halter & Griswold LLP
(1L only) ________
7-10 weeks
Carlile Patchen & Murphy LLP
(1L only) ________
11+ weeks
Chester Willcox & Saxbe LLP
(Taft, Stettinius & Hollister effective 1/2/12)
Crabbe, Brown & James, LLP
(2L only) ________
7-10 weeks
(1L only) ________
11+ weeks
Dinsmore & Shohl LLP
(1L only) ________
7-10 weeks
Hahn Loeser & Parks LLP
(1L only) ________
7-10 weeks
Honda of America Mfg., Inc.
(2L only) ________
11+ weeks
Jones Day
(1L only) ________
7-10 weeks
Maguire & Schneider, LLP
(1L or 2L) ________
7-10 weeks
Nationwide, Office of General Counsel
(1L only) ________
11+ weeks
Porter Wright Morris & Arthur LLP
(1L only) ________
7-10 weeks
Reminger Co., LPA
(2L only) ________
7-10 weeks
Roetzel & Andress
(1L only) ________
10 weeks
Schottenstein Zox & Dunn Co., LPA
(Ice Miller effective 1/1/12)
Squire Sanders & Dempsey (US) LLP
(1L only) ________
8-12 weeks
(1L only) _________
7-10 weeks
Thompson Hine LLP
(2L only) ________
7-10 weeks
Vorys, Sater, Seymour and Pease LLP
(1L only) ________
10 weeks
Wiles, Boyle, Burkholder & Bringardner Co. LPA
(1L or 2L) ________
7-10 weeks
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APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
If you are interested in ONLY private sector employment, please STOP and continue to PART I: Recommendation Form.
If you are also interested in public sector employment, please continue to Public Sector.
Public Sector:
I am interested in being considered by up to 4 of the following public sector employers:
Columbus City Attorney
(1L only) ________
7-10 weeks
Franklin County Prosecuting Attorney
(1L only) ________
11+ weeks
Ohio Attorney General
(1L or 2L) ________
11+ weeks
Office of Disciplinary Counsel,
Supreme Court
(2L only) ________
7-10 weeks
PART I:
Recommendation Form
A completed recommendation form from an undergraduate or law school professor is required. This form is part of your application
package and must be returned by the due date for your application to be considered complete. It is suggested you include the
recommendation form with your application. If the referring professor wants to complete it and send it in separately, you are still
responsible for the recommendation’s arrival by the application due date. (Label as Addendum C)
PART J:

Additional Disclosures:
Please report and attach a statement describing in detail any misdemeanor and felony convictions (other than minor traffic
violations and juvenile offenses). A conviction does not automatically disqualify an applicant.
If yes, please check. ____

(Label statement as Addendum D)
Please indicate ethnic and racial identity.
Race / Ethnicity: _____________________________

Please complete the “Student Reference Request and FERPA Release.”
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APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
PART K:
Statement of Agreement and Commitment
In signing this statement, I certify that:
1.
I understand this program is not a hiring tool, but an opportunity to gain valuable clerkship experience. Regardless of
performance during the summer, students should not expect a clerkship through this program to produce an offer of future
employment.
2.
I understand it is my responsibility to ensure all required forms and supporting material reach the Columbus Bar Association
by the due date. Failure to submit this information will result in the rejection of my application.
3.
I understand this program is intensive and requires my full-time commitment. Upon acceptance of a clerkship position, I will
not solicit, accept or participate in classes, externships or employment of any kind, during the clerkship period. Upon
acceptance of a clerkship, I also agree to complete the program in its entirety.
4.
The information provided by me in this application is complete, true, and accurate. I understand that any misrepresentation
or omission may be cause for disqualification or result in expulsion from the program.
5.
The Columbus Bar Association has the right to terminate my clerkship immediately if: (1) I am no longer enrolled or become
ineligible to remain enrolled in law school; (2) I am placed on academic probation at any time before or during my clerkship
(even if my academic probation is subsequently reversed); (3) Absence from the following mandatory activities: interview
and orientation; (4) it has been determined that I conducted myself in an unprofessional or unethical manner.
6.
I understand the information submitted in this application will be shared with the Columbus Bar Association, potential
employers, and the academic institution at which I am enrolled.
7.
If for any personal reasons I must leave the program, I must call and notify the Columbus Bar Association.
__________________________________________________ ______________________________________________
Signature of Applicant
Date
Page 7 of 9
APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
Student Reference Request and FERPA Release
Student Name: ________________________________________________________________
I request the following person to serve as a reference for application to the Columbus Bar Association’s Minority Clerkship Program.
Check One:
_____
Assoc. Dean Rachel Janutis (Capital)
_____
Asst. Dean Robert Solomon (Moritz)
The reference may be given in the following form(s): (please check one or both spaces)
_____
Written
_____
Oral
I authorize the above person to release information and provide an evaluation about my academic standing and rank; and any and all
information regarding ethics violations from my educational records at the ________________________________________ law
school, as deemed necessary by the above person to provide the reference to The Columbus Bar Association’s Minority Clerkship
Program.
I understand further that:
1. I have the right not to consent to the release of my education records;
2. This consent shall remain in effect until revoked by me, in writing, and delivered to the above- named person to whom this
release is granted, but that such revocation shall not affect disclosures previously made by the above-named person prior to
receipt of any such written revocation.
I ____ waive (OR) _____do not waive (check one) my right under FERPA to review and receive a copy of any reference provided
pursuant to this authorization. I understand that if I waive the right to review and receive a copy of this reference, that I will not have
the right to inspect such a document at a later date.
Student signature __________________________________________
Date: _____________________
Page 8 of 9
APPLICATION
COLUMBUS BAR ASSOCIATION
2XXX MINORITY CLERKSHIP PROGRAM
Recommendation Form
Candidate’s Name: ______________________________________________
1.
How long have you known the candidate?_______________________
2.
In what context(s) have you known the candidate?
_____________________________________________________________
3.
Please place check marks that represent your evaluation of this student in comparison with other students. If you have no fair
basis for judgment, please indicate so.
No basis for
judgment
Below Average
Average
Above
Average
40%)
(top
Excellent (top
20%)
One of top few
Personal Qualities
Energy & initiative
Independence
Emotional maturity
Self confidence
Respect from others
Academic Characteristics
Motivation
Originality
Oral communication
Written communication
Dependability and Disciplined work
habits
Problem solving ability
Overall Evaluation
4.
Please provide any information you believe should be known about the applicant that could affect their success in this
program (e.g. level of maturity, ability to relate to other students and adults, problems at school or the community, tardiness,
class participation, etc.)
___________________________________________________________________________________________________
___________________________________________________________________________________________________
5.
Recommender Information
____________________________________________
Full Name
____________________________________________________
Position
____________________________________________
Signature
____________________________________________________
Date
Thank you very much for your time and consideration. We appreciate your candor and professionalism.
Please enclose and seal your form and return to the applicant.
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