ELS & IP Clinic Request Form
Fill out the form carefully to receive permission for enrollment.
This Form Must Be Approved BEFORE you enroll. Space in the Clinic is limited.
Approval will be sent to you via email from merrickda@umkc.edu
No student may simultaneously enroll in more than one Clinic, Externship/Field Placement without first disclosing this intended schedule to all of the supervising Professors and obtaining their consent prior to enrollment.
Student Name
First Name
Middle Name
Last Name
Gender
Please select Male, Female, or N/A.
Male
Female
N/A
Please select Male, Female, or N/A.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Company- If Working Outside Law School
Expected Graduation Date - Indicate if JD or LL.M.
Clinic Enrollment Requested
Please select Entrepreneurial Legal Services Clinic or Intellectual Property Clinic
Entrepreneurial Legal Services Clinic
Intellectual Property Clinic
Semester Requested
Business/Tax/IP Courses taken (Please state semester/year).
Submit Application
Clear Fields
Should be Empty: