Clinic Registration Form – Youth organization

Applicant Information

This application should be completed by a Team Lead, Manager or Director of the organization only.

Applicant’s Full Name (Adult)(Required)

Designation(Required)

Gender(Required)

Contact No.(Required)

Home/Office, Handphone

Nationality(Required)

Preferred Language(Required)

Email Address(Required)

Work Address(Required)

Nationality (Others)

Member Organization(Required)

How did you hear about YWAS Legal Clinic(Required)

Member Organization (Others)

How did you hear about YWAS Legal Clinic (Others)

CASE DETAILS

I acknowledge that the legal advice given by the volunteer lawyers in this clinic is based on the information provided by me. I am responsible for the accuracy of the information I have given, and I understand and acknowledge that the volunteer lawyers are not liable for any advice given based on incomplete or inaccurate information.

In receiving the advice at the Clinic, I accept and agree that there is no solicitor-client relationship established between myself and the volunteer lawyers nor the firms nor organisations they represent and hold no person nor organisation liable nor responsible for reliance on such advice.

I understand that legal advice does not amount to legal representation and agree that the volunteer lawyers who provide the legal advice make no commitment to represent the applicant in Court and are not permitted to take on representation of any applicants for a fee.

What is the nature of your legal question? Click all that apply and complete the field below if you are not sure.(Required)

I may be / have been charged with a crime

I am / may be a victim of a crime

Family/Partner Violence

Violence, Harassment, or Bullying, by others

Marriage and Divorce

Child/Spousal Maintenance

Child Protection

Child Issues (custody, care and control, access)

Wills and Probate

Consumer Contracts

Employment

Others:

If you have selected “Others”, please specify:

Elaborate what the issue is

Please go through the above again and ensure you have provided all the necessary information before you submit this form. This is so that lawyers (assisted by law students from NUS, SMU and SUSS) can familiarise themselves with your issue ahead of the appointment. The more information you provide, the better prepared our lawyers can be.

Where relevant, please scan and upload any supporting documents, such as copies of contracts & agreements, emails, letters, and legal papers.

Drop files here or

Accepted file types: doc, docx, ppt, pptx, xls, xlsx, pdf, img, jpg, jpeg, png, gif, zip, Max. file size: 1 MB.

Please limit your file name to 20 characters and attachment size to 1MB. Allowed file types: doc, docx, ppt, pptx, xls, xlsx, pdf, img, jpg, jpeg, png, gif, zip.

Consent(Required)

I agree and read(Required)

Consent for Use of Personal Data:

I understand and agree that the personal data which I provide herein is for the purposes of my application for a YWAS Legal Clinic (“Clinic”). I warrant that it is true and accurate as at the time of disclosure. I authorise YWAS to collect and retain this personal data for the purposes of my attendance at the Clinic and any related purposes and acknowledge that the data will be shared with such persons as necessary for the administration and operation of the Clinic. I agree that YWAS may contact me for any purposes related to the Clinic.

Disclaimer of Liability:

The purpose of the free legal clinic is to provide gratuitous advice to all YWAS members. The advice given at these clinic sessions shall be as a matter of guidance and comfort only and is not intended to replace, substitute or supplement official legal advice and or legal action that may be needed in each case. The information provided by the attendee to the volunteer lawyers at these clinic sessions shall be kept confidential. Please note that the volunteer lawyers are under a legal prohibition to not act any further for the attendee who attends at these sessions.

However, should you require legal representation, you may make a request to the attending lawyer, and Allen and Gledhill LLP may follow up to assess your suitability. Allen and Gledhill LLP reserves the right to decide if they should make any representation.

For the gratuitous advice given at these sessions, the clinic and its volunteer lawyers shall not be liable in any way whatsoever for any such advice or information provided at these sessions. By submitting this form, I hereby confirm that, I understand the role of the volunteer lawyers and the above disclaimer of liability and I agree not to hold the volunteer lawyers or the clinic responsible for any advice, guidance, and/or information given.

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