Applicants's Certification of Supervised Practice Completion

I hereby certify that I have completed the practice requirements of the supervised practice program of the Nevada State Bar comprehensive licensing examination.

I further state and attest as follows:

Name of Applicant*

First NameMiddle NameLast Name

Applicant Email*

Dates of Supervised Practice:*

You may enter the starting and ending months and year.

I completed my supervised practice through*

Clinical courses at ABA-accredited law schools that do not charge clients for their servicesExternships at government or nonprofit entities taken through ABA-accredited law schoolsLegal aid program approved by the Access to Justice CommissionA governmental office in NevadaAttorney in private practice working on a pro bono case providing by an approved Access to Justice legal aid office in the State of Nevada

My supervised practice was*

in Nevada.outside of Nevada.

Provide the name of the clinic, organization, office, or agency where you completed your supervised practice:*

Provide the full, official name of the entity. Do not abbreviate or use acronyms.

Provide the name of your supervising attorney:*

First NameLast Name

Provide the email address for the supervisor's certification:*

example@example.com

I attest that*

I completed at least 40 hours of supervised practice; ANDDuring the program I remained properly certified under SCR 49.3 level 2; ORMy practice occurred outside of Nevada, and I remained properly certified under an equivalent rule to SCR 49.3 level 2 during the course of my supervised practice.

What state and rule were you certified under?*

Pursuant to SCR 66.3(e) I further attest that I participated in at least 4 required lawyering tasks:*

Interviewing or counseling a client (or appropriate substitute for in house counsel and prosecuting attorney's offices).Discussing the client’s needsPreparing a strategic approachConducting legal researchDrafting correspondencePreparing documents for the clientNegotiating/mediating/arbitratingAppearing before a court/tribunal

Pursuant to SCR 66.3(f) I further attest that*

All matters undertaken during supervised practice have concluded.I continue to represent the client in matters I undertook during supervised practice pursuant to my SCR 49.3 level 2 certification.Exigent circumstances required withdrawal, and I complied with Rule 66(3)(f) and ensured that the client’s rights and interests were not prejudiced.

By signing below, I hereby attest that the above statements are true and accurate and that I have satisfactorily completed the practice experience of the Nevada Supervised Practice Program pursuant to SCR 66(3)(h).

Signature*

Date