Do you need to resolve the division of assets/debts Yes No

Parenting plan for children Yes No

Child and/or spousal support matters Yes No

It is mandatory that both spouses agree to particpate in the pro bono program. Have you spoken to your spouse and are you both willing to participate in settlement meetings to resolve these matters? Yes No

Can we contact both you and your spouse together when we respond to your application, or would you like to speak with us first about the program before reaching out to your spouse? Please Respond to both Please contact me first about the program

Do you and your spouse have a combined gross annual income of less than $150,000? Yes No

Do you and your spouse have less than $200,000 in assets, excluding pension plans? Yes No

Do you have minor children? Yes No

If yes, ages of children: *