Request for Pro Bono Legal Assistance
Pro Bono Partnership of Atlanta (PBPA) assists qualifying 501(c)(3) nonprofit organizations with their business legal needs. This form and the required documents listed below will help PBPA learn more about your organization and its legal needs.
We also collect information to provide demographic data to ratings organizations, such as Guidestar, and grant-making organizations that request such information. No information collected through this survey will be used in making decisions to provide services.
Given our limited capacity, we cannot accept every applicant as a client.
In addition to our eligibility criteria,
we consider the overall sustainability of each organization.
Please note that PBPA does not assist individuals or for-profit organizations.
Organization Details
Legal Name of Organization
Trade Name or DBA if applicable
Street
City
State
Zip Code
County
Country
Organization Phone
Website
Contact Information
Salutation
Please select...
Mr.
Ms.
Mrs.
Dr.
Prof.
First Name
Last Name
Phone Number
Contact Email
Title
How long have you held this position?
Are you the organization's Executive Director?
Yes
No
Executive Director Demographics
Executive Director's Gender
Female
Male
Non-binary
Prefer to self-describe
Prefer not to answer
Executive Director's Race
Asian American or Pacific Islander
Black or African American
Hispanic or Latino
Native American
White/Caucasian
Prefer not to answer
Additional Organization Information
Provide your organization's Mission Statement
Please describe how your organization serves low-income and disadvantaged individuals:
What percentage of the community served is low-income? ("Low-income" is defined as 80 percent of the median household income for the area.)
How
many people
does your organization serve?
State of Incorporation
Please select...
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
Washington-DC
WI
WV
WY
Date of Incorporation
Date of IRS Tax Exemption
EIN
What is your organization's annual budget for the current year?
What is the total gross receipts/revenues from the most recent fiscal year?
# of paid staff
# of independent contractors
# of volunteers
Please tell us where you heard about the Pro Bono Partnership of Atlanta.
Please select...
Funder
Website/Internet Search
Nonprofit Notes/Email
PBPA Presentation
PBPA Workshop/Webcast
Social Media
Referred by another nonprofit
Attorney or Law Firm
Consultant
Other
If referred by a person, who referred you to Pro Bono of Atlanta?
Service Areas
Please list your organization's service areas (for example, Literacy, Childcare, and Housing/Shelter)
Use the below fields to identify the main areas and sub-areas your organization serves. Please see link for an overview of the areas
https://taxonomy.candid.org/subjects
Guidestar Main Area
Please select...
Agriculture, fishing and forestry
Arts and culture
Community and economic development
Education
Environment
Health
Human services
Information and communications
International relations
Philanthropy
Public affairs
Religion
Science
Social sciences
Sports and recreation
Human rights
Public safety
Guidestar Main Sub-Area
Please select...
Agriculture
Fishing and aquaculture
Food security
Forestry
Arts services
Cultural awareness
Folk arts
Historical activities
Humanities
Museums
Performing arts
Public arts
Visual arts
Business and industry
Community improvement
Economic development
Financial services
Housing development
Sustainable development
Adult education
Early childhood education
Education services
Educational management
Elementary and secondary education
Equal opportunity in education
Graduate and professional education
Higher education
Student services
Vocational education
Biodiversity
Climate change
Domesticated animals
Environmental education
Environmental justice
Natural resources
Diseases and conditions
Health care access
Health care administration and financing
Health care quality
Holistic medicine
In-patient medical care
Medical specialties
Medical support services
Mental health care
Nursing care
Out-patient medical care
Public health
Rehabilitation
Reproductive health care
Traditional medicine and healing
Antidiscrimination
Diversity and intergroup relations
Individual liberties
Justice rights
Social rights
Basic and emergency aid
Family services
Human services information
Human services management
Job services
Personal services
Shelter and residential care
Special population support
Youth development
Communication media
Information and communications technology
Libraries
Media access and policy
News and public information
Foreign policy
Goodwill promotion
International development
International economics and trade
International exchange
International peace and security
Multilateral cooperation
Foundations
Nonprofits
Philanthropy and public policy
Venture philanthropy
Voluntarism
Democracy
Leadership development
National security
Public administration
Public policy
Public utilities
Public/private ventures
Abuse prevention
Consumer protection
Corrections and penology
Courts
Crime prevention
Disasters and emergency management
Fire prevention and control
Legal services
Safety education
Biology
Engineering
Forensic science
Mathematics
Physical and earth sciences
Technology
Anthropology
Economics
Geography
Interdisciplinary studies
Law
Paranormal and mystic studies
Political science
Population studies
Psychology and behavioral science
Sociology
Community recreation
Sports
Guidestar 2nd Area
Please select...
Agriculture, fishing and forestry
Arts and culture
Community and economic development
Education
Environment
Health
Human services
Information and communications
International relations
Philanthropy
Public affairs
Religion
Science
Social sciences
Sports and recreation
Human rights
Public safety
Guidestar 2nd Sub-Area
Please select...
Agriculture
Fishing and aquaculture
Food security
Forestry
Arts services
Cultural awareness
Folk arts
Historical activities
Humanities
Museums
Performing arts
Public arts
Visual arts
Business and industry
Community improvement
Economic development
Financial services
Housing development
Sustainable development
Adult education
Early childhood education
Education services
Educational management
Elementary and secondary education
Equal opportunity in education
Graduate and professional education
Higher education
Student services
Vocational education
Biodiversity
Climate change
Domesticated animals
Environmental education
Environmental justice
Natural resources
Diseases and conditions
Health care access
Health care administration and financing
Health care quality
Holistic medicine
In-patient medical care
Medical specialties
Medical support services
Mental health care
Nursing care
Out-patient medical care
Public health
Rehabilitation
Reproductive health care
Traditional medicine and healing
Antidiscrimination
Diversity and intergroup relations
Individual liberties
Justice rights
Social rights
Basic and emergency aid
Family services
Human services information
Human services management
Job services
Personal services
Shelter and residential care
Special population support
Youth development
Communication media
Information and communications technology
Libraries
Media access and policy
News and public information
Foreign policy
Goodwill promotion
International development
International economics and trade
International exchange
International peace and security
Multilateral cooperation
Foundations
Nonprofits
Philanthropy and public policy
Venture philanthropy
Voluntarism
Democracy
Leadership development
National security
Public administration
Public policy
Public utilities
Public/private ventures
Abuse prevention
Consumer protection
Corrections and penology
Courts
Crime prevention
Disasters and emergency management
Fire prevention and control
Legal services
Safety education
Biology
Engineering
Forensic science
Mathematics
Physical and earth sciences
Technology
Anthropology
Economics
Geography
Interdisciplinary studies
Law
Paranormal and mystic studies
Political science
Population studies
Psychology and behavioral science
Sociology
Community recreation
Sports
Guidestar 3rd Area
Please select...
Agriculture, fishing and forestry
Arts and culture
Community and economic development
Education
Environment
Health
Human services
Information and communications
International relations
Philanthropy
Public affairs
Religion
Science
Social sciences
Sports and recreation
Human rights
Public safety
Guidestar 3rd Sub-Area
Please select...
Agriculture
Fishing and aquaculture
Food security
Forestry
Arts services
Cultural awareness
Folk arts
Historical activities
Humanities
Museums
Performing arts
Public arts
Visual arts
Business and industry
Community improvement
Economic development
Financial services
Housing development
Sustainable development
Adult education
Early childhood education
Education services
Educational management
Elementary and secondary education
Equal opportunity in education
Graduate and professional education
Higher education
Student services
Vocational education
Biodiversity
Climate change
Domesticated animals
Environmental education
Environmental justice
Natural resources
Diseases and conditions
Health care access
Health care administration and financing
Health care quality
Holistic medicine
In-patient medical care
Medical specialties
Medical support services
Mental health care
Nursing care
Out-patient medical care
Public health
Rehabilitation
Reproductive health care
Traditional medicine and healing
Antidiscrimination
Diversity and intergroup relations
Individual liberties
Justice rights
Social rights
Basic and emergency aid
Family services
Human services information
Human services management
Job services
Personal services
Shelter and residential care
Special population support
Youth development
Communication media
Information and communications technology
Libraries
Media access and policy
News and public information
Foreign policy
Goodwill promotion
International development
International economics and trade
International exchange
International peace and security
Multilateral cooperation
Foundations
Nonprofits
Philanthropy and public policy
Venture philanthropy
Voluntarism
Democracy
Leadership development
National security
Public administration
Public policy
Public utilities
Public/private ventures
Abuse prevention
Consumer protection
Corrections and penology
Courts
Crime prevention
Disasters and emergency management
Fire prevention and control
Legal services
Safety education
Biology
Engineering
Forensic science
Mathematics
Physical and earth sciences
Technology
Anthropology
Economics
Geography
Interdisciplinary studies
Law
Paranormal and mystic studies
Political science
Population studies
Psychology and behavioral science
Sociology
Community recreation
Sports
Demographics of Populations Served
Gender:
Please enter the percentage of each group served by your organization. Percentages entered should equal
100%.
Enter
"0"
if you do not track.
Female
Male
Non-binary
Race:
Please enter the percentage of each group served by your organization. Percentages entered should equal
100%.
Enter
"0"
if you do not track.
Asian American or Pacific Islander
Black or African American
Hispanic Latino
Native American
White/Caucasian
Other
Age:
Please enter the percentage of each group served by your organization. Percentages entered should equal
100%.
Enter
"0"
if you do not track.
Youth (0-18 years old)?
Adults (19-55 years old)?
Seniors (55+ years old)?
Does your nonprofit serve the City of Atlanta and inside the perimeter?
Yes
No
If you serve the City of Atlanta, please select the neighborhoods that your organization serves:
Bankhead
Cabbage Town
Candler Park
Capitol View
Castleberry Hill
Clarkston
Decatur
Downtown/Sweet Auburn
East Atlanta
East Lake
Edgewood
Georgia Tech
Grant Park
Gresham Park
Grove Park
Hunter Hills
Inman Park
Just Us
Kirkwood
Mechanicsville
Midtown
Oakland City
Old Fourth Ward
Ormewood
Peoplestown
Piedmont Park
Poncey Highlands
Reynoldstown
Summer Hill
Underwood Hills
Vine City
West End
Westside
N/A
Where does your nonprofit serve? Please select the choice that fits best.
Metropolitan Atlanta (select counties below)
Counties throughout Georgia (select counties below)
Statewide
National Organization
Serves outside the US
The counties you serve in Metropolitan Atlanta:
All counties in Atlanta
Barrow
Bartow
Butts
Carroll
Cherokee
Clayton
Cobb
Coweta
De Kalb
Douglas
Fayette
Forsyth
Fulton
Gwinnett
Hall
Henry
Morgan
Newton
Paulding
Pickens
Rockdale
Spalding
Walton
The counties you serve in Georgia:
All counties in Georgia
Appling
Atkinson
Bacon
Baker
Baldwin
Banks
Barrow
Bartow
Ben Hill
Berrien
Bibb
Bleckley
Brantley
Brooks
Bryan
Bulloch
Burke
Butts
Calhoun
Camden
Candler
Carroll
Catoosa
Charlton
Chatham
Chattahoochee
Chattooga
Cherokee
Clarke
Clay
Clayton
Clinch
Cobb
Coffee
Colquitt
Columbia
Cook
Coweta
Crawford
Crisp
Dade
Dawson
Decatur
De Kalb
Dodge
Dooly
Dougherty
Douglas
Early
Echols
Effingham
Elbert
Emanuel
Evans
Fannin
Fayette
Floyd
Forsyth
Franklin
Fulton
Gilmer
Glascock
Glynn
Gordon
Grady
Greene
Gwinnett
Habersham
Hall
Hancock
Haralson
Harris
Hart
Heard
Henry
Houston
Irwin
Jackson
Jasper
Jeff Davis
Jefferson
Jenkins
Johnson
Jones
Lamar
Lanier
Laurens
Lee
Liberty
Lincoln
Long
Lowndes
Lumpkin
Macon
Madison
Marion
McDuffie
McIntosh
Meriwether
Miller
Mitchell
Monroe
Montgomery
Morgan
Murray
Muscogee
Newton
Oconee
Oglethorpe
Paulding
Peach
Pickens
Pierce
Pike
Polk
Pulaski
Putnam
Quitman
Rabun
Randolph
Richmond
Rockdale
Schley
Screven
Seminole
Spalding
Stephens
Stewart
Sumter
Talbot
Taliaferro
Tattnall
Taylor
Telfair
Terrell
Thomas
Tift
Toombs
Towns
Treutlen
Troup
Turner
Twiggs
Union
Upson
Walker
Walton
Ware
Warren
Washington
Wayne
Webster
Wheeler
White
Whitfield
Wilcox
Wilkes
Wilkinson
Worth
Does your nonprofit serve in other states outside of Georgia?
Yes
No
If serving states outside of Georgia, what states do you serve in?
Does your organization serve countries outside the United States?
Yes
No
If serving outside of the United States, list the countries serving:
Board Information
# of Board Members
How often does the board of directors meet?
Board Chair Name
Board Chair Phone
Board Chair Email
Names of Board Members
Legal Request
Is there a line item on your budget for legal fees?
Yes
No
If there is a line item on budget for legal fees, how much is it?
Please describe the specific kinds of legal assistance you now need or anticipate needing in the future:
Please provide the name and affiliation of any lawyer that is now helping your organization or has helped your organization in the past five years, briefly describing the services provided. (Put NA if not applicable.)
Please provide the name, phone number, email and affiliation of any attorney that sits on the organizations board of directors.
(Put NA if not applicable.)
Additional Documents
Please attach a copy of your 501(c)(3) letter from the
IRS.
You may also attach a brochure or additional information about your
organization, if desired. (Optional document #1)
You may also attach a brochure or additional information about your
organization, if desired. (Optional document #2)
You may also attach a brochure or additional information about your
organization, if desired. (Optional document #3)
Thank you for your application. We will reach out to you once we have reviewed the application.
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Contact Information