PERSONAL INFORMATION

First  Name:

 Middle Name: 

 Last Name:

 Surname (maiden name or other surnames used - enter more than one name by separating with a semi-colon):

Preferred Name: 

Date of Birth (mm/dd/yy): 

PLACE OF BIRTH -    City: 

   State: 

Citizenship: 

If non-US citizen, Residency/Visa Status:

PRESENT MAILING ADDRESS -   Street: 

                                                City: 

  State:  Zip 

Present Telephone:

Area Code  -    

  Cell Phone Number:

Area Code  -    

Present E-Mail address:  

(yourname@server.com)

PERMANENT MAILING ADDRESS -   Street: 

City:

  State:  Zip 

Permanent Telephone:

Area Code  -    

After what date should permanent address be used? 

 (mm/dd/yy)

APPLICATION PROCESSING INFORMATION

 Please indicate acceptance status:

Notre Dame Law School   Accepted Awaiting Decision N/A This school is my preference
Kansas University School of Law   Accepted Awaiting Decision N/A This school is my preference
Washburn School of Law   Accepted Awaiting Decision N/A This school is my preference

Please indicate current education status:

  I am currently applying to enter Law School Next Year.
I am currently a 1L in law school, applying for a scholarship for my 2nd year.
  I am currently a 2L in law school, applying for a scholarship for my 3rd year.

RESIDENCY
Have you been a resident of Kansas for at least ten (10) years?  yes   no  
(If yes, complete questions a through h.) 
a.  When did you begin living continuously in Kansas? (mm/yy)
b.  Where did you live prior to the date above?
City   State:    from (yr) to (yr)
City   State:    from (yr) to (yr)

c.  With what state did you /will you file your tax return in the last tax year?

d.  Did / will your parents or legal guardian claim you as a tax dependent in the last tax year?
  yes  no

e.  With what state did / will your parents or legal guardian file their tax return in the last tax year?       

f.  What state issued the current license plate on your car?

g.  What state issued your current driver's license? 

h.  Driver's License Number:      Date Issued:  (mm/yy)

HIGH SCHOOL, COLLEGE & UNIVERSITY ATTENDANCE

List below (In order of attendance) all colleges, universities and professional schools that you have attended.

High School

Name of School
City and State  
Dates of Attendance (mm/yy - mm/yy) to
Date Awarded Diploma (mm/yy)

College #1

Name of College
Major
Minor
Dates of Attendance (mm/yy - mm/yy) to
Degree Awarded
Date Awarded (mm/yy)

College #2
Name of College
Major
Minor
Dates of Attendance (mm/yy - mm/yy) to
Degree Awarded
Date Awarded (mm/yy)

College #3
Name of College
Major
Minor
Dates of Attendance (mm/yy - mm/yy) to
Degree Awarded
Date Awarded (mm/yy)

EMPLOYMENT HISTORY

Employer #1  (List most recent first)
Employer
Position
Dates of Employment From (mm/yy) to (mm/yy)

Employer #2 
Employer
Position
Dates of Employment From (mm/yy) to (mm/yy)

Employer #3 
Employer
Position
Dates of Employment From (mm/yy) to (mm/yy)

Employer #4 
Employer
Position
Dates of Employment From (mm/yy) to (mm/yy)

ACCOMPLISHMENTS AND ACTIVITIES
Have you ever served in the armed forces?  Yes        No

CHARACTER AND FITNESS

Please check "yes" or "no" for each question.  If any question is answered "yes", you must submit separately a full explanation for each question so answered.  Please also note that there are character, fitness, and other qualifications for admission to the bar of all states.

a.  Yes    No   Have you ever been subject to any disciplinary action for scholastic reasons, or other reasons, in any of the secondary schools, colleges, or universities you have attended?

b.  Yes    No   Have you ever been charged with a military offense? 

c.  Yes   No   Have you ever been charged with a felony, misdemeanor, or infraction, or a traffic violation involving alcohol or controlled substance?  If yes, your explanation should give date, nature of offense or proceeding, name and location of the court, and disposition of the matter.

d.  Yes    No    Have you ever been convicted of a crime?

LETTERS OF RECOMMENDATION
Two letters of recommendation are required.  These should be from persons who know you well enough to comment substantively as to your scholastic ability, your extracurricular activities, your character in the community and/or your work experiences.  List below the names of people submitting your recommendations.
1. 
2. 

LSAT

List all dates on which you have taken or plan to take the Law School Admission Test.  List scores if available.  If you decide to retake the LSAT after you submit this application, be sure to inform us.
Most recent date LSAT taken (mm/yy)  Score 
Other date LSAT taken (mm/yy)  Score 

KANSAS INTEREST
In the event you are a recipient of a scholarship, would you consider a law firm, or other prospective employer, in the State of Kansas:

For summer Clerkship    Yes     No 

For post graduate employment   Yes    No

RELEASE
Are you willing to provide a Release allowing the Trust to obtain and/or verify all information you have provided in this application as well as providing supplemental verification information?  Yes     No

Send mail to claudette@jlweigandtrust.org with questions or comments about this web site.
Copyright © 2007 The J.L. Weigand, Jr. Notre Dame Legal Education Trust
Last modified: 11/15/07