General Counsel Program Application

Please complete the form below to apply for our General Counsel Program. All applications are reviewed with the utmost discretion and confidentiality.

Name

First Name

Last Name

Company/ Organization Name

Title/ Role

Phone

(###)

###

####

What tier of representation are you interested in?

Essential Counsel ($999/ month)

Growth Partner ($1,749/ month)

Executive Access ($2,499/ month)

Company Details

Please include: Business Type Industry/Sector Years in Operation Number of Employees Brief Description of Your Business/Organization:

Legal Needs & Goals

What are your primary legal needs or concerns? (Briefly describe) Have you worked with outside counsel or in-house counsel before? What do you hope to achieve through the General Counsel Program? Is there a particular area (contracts, IP, HR, etc.) where you anticipate most of your questions?

Additional Information

Why do you believe your organization is a good fit for this exclusive program? Is there any other information you would like us to consider?