Applicants's Certification of Supervised Practice Completion

Applicants's Certification of Supervised Practice Completion
Submit this form to certify your practice experience component of the Supervised Practice Program complete.

For more information, you may view the Supreme Court Rules for:

Limited practice for students or graduates - Rule 49.3
Supervised Practice Program - Rule 66

The Standards for Applicant Participation are also available at nvbar.org/nvplan/spp.
Certification
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
My supervised practice was
Which legal aid office?
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 for the supervisor's certification:

First NameLast Name
Provide the email address for the supervisor's certification:
example@example.com
Which legal aid organization provided the pro bono case you worked on?
Certification
I completed at least 40 hours of supervised practice.
Pursuant to SCR 66.3(d), I attest that

Other
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:
Pursuant to SCR 66.3(f), I further attest that
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

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: