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Locum Panel Registration Form

Locum Panel Registration Form

Complete this form to join the national Locum Panel.

Personal Details

Title

Surname

First names

Firm or practice name

Law Society Branch

Phone number

Email address

Address

Year of admission

Experience/Qualifications

Practice Areas ACC Arbitration Administrative/Public Bank/Finance Civil Litigation Company/Commercial Criminal Employment Family Health Immigration In-house counsel Insurance Intellectual Property Lending Activities Media law Mediation Privacy law Property Resource Management Selling Real Estate Tax Treaty/Maori Trusts and Estates Other - please list below

(Optional)

Please give an indication of your experience and/or qualifications to provide advice for the practice areas you have ticked.

Practice on own account? Yes No

Trust account supervisor? Yes No

Are you prepared to work anywhere in New Zealand? Yes No

Please give an indication below of the areas/localities you are prepared to work in: (Optional)

Referees

Referee 1

Referee 2

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Professional practice
Practising Well
Locum Panel
Locum Panel Registration Form

Page updated: 23/09/2022

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