PLACEMENT SERVICES APPLICATION - Louisville Bar Association
Call 583-5314 for further info.

The Louisville Bar Association Placement Service matches area law firms seeking legal support
staff with qualified employees. The service refers legal secretaries, paralegals, receptionists,
and other legal support staff for permanent positions. All applications are confidential.
No references will be checked without your prior consent.

Please check or fill in every section of the application, even if the information is on your resume.

Date: ________________

Name: ___________________________________

Address: _____________________________________________________________

Telephone Home: ___________________ Telephone Work: ___________________

Telephone Cellular: ____________________ E-mail Address ___________________

Why are you seeking employment at this time? _____________________________

____________________________________________________________________

Position(s) Desired:

Regular Full Time Regular Part Time Either Full Time or Part Time

Temporary job referrals accepted? Yes No

Temporary to permanent positions accepted? Yes No

Position Location Preference: (check all you would consider)

Downtown Indiana Suburbs ________________ (list)

Size of Firm:

Large (46+) Medium (11-45) Small (2-10) Sole Practitioner No Preference

Salary: Current/Most Recent: _________________ Desired Salary Range: ______________

Benefits:

Would you consider a position without health insurance benefits?
Yes No Maybe (depending on salary/other benefits)

List other benefits desired: _____________________________________________________

Availability for Hire:

Immediately 1 Week Notice 2 Weeks Notice Specific Date _________________

Your Skills:

Typing ____ wpm speed Shorthand ____wpm Multi-line phone
Time Entry Dictation Equipment Bookkeeping E-File
Microsoft Word Version(s) __________ WordPerfect Version(s) __________ Macintosh
Lotus Excel PowerPoint Access Quicken Quattro Pro
Outlook Timeslips Pro Law
Other: ____________________________________________

List other skills or equipment: _____________________________________________

_________________________________________________________________________

List areas of legal practice experience: _____________________________________

_________________________________________________________________________

Years of Experience:

Legal Secretary _________ Other Secretarial _________ Word Processor _________

Receptionist _________ Clerk/Typist _________ Paralegal ______ Office Mgmt _________

Other _________________

--------------------------------------------------------------------

Educational Background:

High School ______________________________ City, State ______________________
High School Diploma GED

College:

School:
Major:
Number Years Attended:
Degree:

School:
Major:
Number Years Attended:
Degree:

Last recorded GPA __________

--------------------------------------------------------------------

Employment History: (List present or most recent employer first and two other employers most relevant to the position you are seeking.)

1. Employer:
City:
State:
Immediate Supervisor:
Phone:
Position held:
Salary:
Employment Dates:
Duties:
Reason for Leaving:

--------------------------------------------------------------------

2. Employer:
City:
State:
Immediate Supervisor:
Phone:
Position held:
Salary:
Employment Dates:
Duties:
Reason for Leaving:

--------------------------------------------------------------------

3. Employer:
City:
State:
Immediate Supervisor:
Phone:
Position held:
Salary:
Employment Dates:
Duties:
Reason for Leaving:

--------------------------------------------------------------------

References:

May we contact all employers listed? Yes No

Employer(s) you do not want contacted: _______________________

Reason ___________________________________________________

Professional References (list two)

Name:
Position:
Phone:

Name:
Position:
Phone

Have you ever been convicted of a felony? Yes No

If yes, please explain: ___________________________________________________________________________

______________________________________________________________________________________________

_____________________________________________________________

The facts set forth in this application are true and complete. I understand that this information may be furnished
to prospective employers and that LBA Placement Services or prospective employers may verify all information.
I further understand that if I am hired for employment as a result of this application process, my employment is
at-will and I may be terminated for any reason or no reason whatsoever.

Signature _____________________________________________ Date _____/_____/______

The LBA Placement Services abides by all applicable laws prohibiting discrimination because of race, color,
religion, sex, national origin, age or disability.

--------------------------------------------------------------------

Writing Sample:

Other than typical benefits available, describe your ideal position in 3-5 sentences.
Please use complete sentences. The content of your writing sample will be reviewed by
employers to evaluate your grammar and writing skills. Please develop your content based on
the positions for which you have applied.

_________________________________________________________________________________

Please provide the following information as completely and accurately as possible.
I have sent resumes to or had interviews with the following law firm or other employers:
(Use back if necessary)

_________________________________________________________________________________

I have an offer(s) pending. Yes No

Employer(s) _______________________________________________________________________

I am currently registered at the following employment agencies:

_________________________________________________________________________________

_________________________________________________________________________________

Where did you hear about our service? Your answer to this question is optional and will not be
used for placement purposes.

_________________________________________________________________________________