AILC/PLSI Bar Review Course Reimbursement and Materials ApplicationPlease enable JavaScript in your browser to complete this form. - Step 1 of 2Application Instructions Use this form to apply for the following: a bar review course reimbursement bar review materials such as Adaptibar, Critical Pass cards, bar support workshops an attorney coach access to a tutor (for re-takers) All information requested is voluntary. However, failure to complete all applicable portions of this application may result in delays in processing or make this application impossible to process. Review the guidelines before completing the form. PLSI DataHave you ever attended PLSI before? *NoYesYear AttendedYear Attended1970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024Personal DataLast Name *First Name *Permanent Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs your mailing address different from your permanent address? *NoYesMailing Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Cell Phone *Other PhoneLaw School *Please spell the name of the institution without acronyms. Highest LSAT Score *For statistical purposes, not for eligibility.Graduation Year *Year1970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024Cumulative GPA *Bar Exam Jurisdiction *Choose JurisdictionAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuam*HawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana Islands*OhioOklahomaOregonPalauPennsylvaniaPuerto Rico*Rhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingUS JurisdictionsUniform Bar Exam *YesNoAnticipated Bar Exam Date *Name of Bar Review Course(s) *Are you seeking supplemental bar exam preparatory materials or an attorney coach? *YesNoSee GuidelinesWhy are you requesting these materials? If Yes, what materials/help are you requesting? EMANUEL'S 7TH EDITION MBE STRATEGY AND TACTICSRIGOS MEE ESSAY BOOKTHE ZEN OF PASSING THE BARADAPTIBARCRITICAL PASS CARDSATTORNEY COACH (These are separate services and the totals are not to be calculated for reimbursement)Will you be employed while studying for the bar? *YesNoIf yes, how many hours per week will you be working? If you have children, please describe your childcare arrangements while studying for the bar exam: Did you receive a scholarship, grant, tuition reduction for the purposes of paying for this bar review course? *YesNoNote: Select, "Yes" if award could only be used to bar for this bar review course. If it could be used for other purposes such as your bar application fees, living expense, etc., select "No"If Yes, please indicate name of source(s) and/or donor(s) AND amount(s) received for each award and date of award below. Sources: Donors:Amount(s) and Date(s): Have you previously taken a state bar exam? *YesNoPlease indicate the following for each previous examination: Bar Exam JurisdictionMonth *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberPass *YesNoBar Review Course(s) *(If any for this bar exam date) Percentage of course completed before sitting for the Bar Exam Selected Value: 0 Were you employed while studying for this bar exam? *YesNoNumbers of Hours/WeekIf you have children, please describe your childcare arrangements while studying for the bar exam:Uniform Bar Exam *YesNoYear of Previous Bar *Year Attended1970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024Scores *Provide a breakdown of scores by section and attach score report form from bar examiners at the end. Please list any supplemental prepatory materials used for this bar exam *(include Critical Pass Cards, Emanuel's MBE Strategices and Tactics, Adaptibar, Etc.)Did you work with an attorney-coach to prepare for this bar exam? *YesNoPlease provide the name of your coach *FirstLastPlease describe the content of your attorney coach meetings Any details are appreciated.How many times did you meet with your coach? *Did you receive a PLSI or AILC Bar review course reimbursement for this Bar exam? *YesNoDo you have additional previous state bar exam attempts? *YesNoIf yes, please specify type (PLSI or AILC) and amount:Please indicate the following for your second Bar Exam attempt: Bar Exam Jurisdiction *Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberPass *YesNoBar Review Course(s) *(If any for this bar exam date) Percentage of course completed before sitting for the Bar Exam Selected Value: 0 Were you employed while studying for this bar exam? *YesNoNumbers of Hours/WeekIf you have children, please describe your childcare arrangements while studying for the bar exam:Uniform Bar Exam *YesNoYear of Previous Bar *Year Attended1970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024Scores *Provide a breakdown of scores by section and attach score report form from bar examiners at the end. Please list any supplemental preparatory materials used for this bar exam *(include Critical Pass Cards, Emanuel's MBE Strategices and Tactics, Adaptibar, Etc.)Did you work with an attorney-coach to prepare for this bar exam? *YesNoPlease provide the name of your coach *FirstLastPlease describe the content of your attorney coach meetingsAny details are appreciated.How many times did you meet with your coach? *Did you receive a PLSI or AILC Bar review course reimbursement for this Bar exam? *YesNoDo you have any other additional previous state bar exam attempts? *YesNoIf yes, please specify type (PLSI or AILC) and amount:Please indicate the following for your third Bar Exam attempt: Bar Exam Jurisdiction *Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberPass *YesNoBar Review Course(s) *(If any for this bar exam date) Percentage of course completed before sitting for the Bar Exam Selected Value: 0 Were you employed while studying for this bar exam? *YesNoNumbers of Hours/WeekIf you have children, please describe your childcare arrangements while studying for the bar examUniform Bar Exam *YesNoYear of Previous Bar *Year Attended1970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024Scores *Provide a breakdown of scores by section and attach score report form from bar examiners at the end. Please list any supplemental preparatory materials used for this bar exam *(include Critical Pass Cards, Emanuel's MBE Strategices and Tactics, Adaptibar, Etc.)Did you work with an attorney-coach to prepare for this bar exam? *YesNoPlease provide the name of your coach *FirstLastPlease describe the content of your attorney coach meetingsAny details are appreciated.How many times did you meet with your coach? *Did you receive a PLSI or AILC Bar review course reimbursement for this Bar exam? *YesNoTribal Data You will be asked to submit your proof of tribal membership before submitting this application. Tribal Affiliation *DegreeEnrollment NumberOther Tribal AffiliationDegreeDocument Upload Section Please Note: Name all documents by Last name, first initial, doc name. PDFs and docx only. Again, incomplete applications will not be considered, so be sure that you have submitted all the necessary documents. Funding is available to qualified applicants until it runs out. See guidelines for further details. Itemized Receipts for Bar Review Course * Click or drag files to this area to upload. You can upload up to 3 files. See Guidelines for eligible courses and invoices.Law School Transcript with Degree Posted * Click or drag a file to this area to upload. Please make sure the transcript includes your name, your school's name, your degree program, and courses. See guidelines. Other Supporting Documents or Memo to AILC Click or drag files to this area to upload. You can upload up to 3 files. Previous Bar Scores * Click or drag files to this area to upload. You can upload up to 3 files. Proof of Membership * Click or drag files to this area to upload. You can upload up to 2 files. Proof of membership in a federally recognized tribe. Submit both sides (front and back) of your Tribal ID card, preferably with the entire card (both sides) in the frame. If the card is expired, please contact your tribe or membership office for a letter of explanation and confirmation of membership. A CDIB can be acceptable if it has your membership status, name, blood quantum, address of agency, and signature of enrollment officer.If you are not enrolled, but are a 1st descendant of a tribal member, please provide that documentation, along with an explanation on why you are not enrolled. Click or drag a file to this area to upload. NextSave and Resume LaterE-SignatureI certify that I have read and understood the 2022-2023 AILC/PLSI Bar Review Course Reimbursement Guidelines and to the best of my knowledge the information contained in this application is true. I understand that any misrepresentation of facts on this application and attachments could be cause for a misconduct investigation and action by AILC for return of the funds. By accepting this reimbursement, I also certify that I will provide the results of the bar examination, including scores, to the AILC within thirty (30) days of receiving the results, and provide all required updated documents described in the guidelines. I authorize the AILC to contact my tribe and law school, if necessary, to verify my information. If I indicated that I want an attorney-coach, I authorize the AILC to provide my contact information to the attorney coach selected by the AILC. Signature Clear Signature Today's DateBack SubmitSave and Resume Later Your form entry has been saved and a unique link has been created which you can access to resume this form. Enter your email address to receive the link via email. Alternatively, you can copy and save the link below. Please note, this link should not be shared and will expire in 30 days, afterwards your form entry will be deleted. Copy Link Email * Send Link