№ lp_2_3_39911
File format: docx
Character count: 4694
File size: 41 KB
Participant intake and acknowledgement form used by a legal aid clinic to collect personal, financial, and case-related information and to document consent and service limitations for a brief legal advice session.
Organization:
Scranton Road Legal Clinic
Document Type:
Participant Intake Form
Purpose:
Collection of personal information and legal issue details for brief advice session
Related Service:
Brief Advice Session
Legal Notice:
No attorney-client relationship established
Fields Included:
Personal Information, Household Information, Income Information, Legal Case Type, Representation Status, Court Dates, Case Manager Information, Emergency Status, Referral Source
Acknowledgement:
Authorization to release information to clinic staff, volunteers, and outside professionals
Signatures Required:
Participant Signature, Attorney Signature
Operational Note:
Donation request of $20
Internal Section:
Attorney Notes and Referral Tracking
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
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The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2025
Region / City:
Scranton
Topic:
Association Meeting Minutes
Document Type:
Minutes
Organization / Institution:
Lee Manor Association
Author:
P. Fleming, A. Skroly, S. Burk, J. Fumex, P. Brandi
Target Audience:
Lee Manor Association members
Effective Period:
April 14th, 2025
Approval Date:
April 14th, 2025
Date of Changes:
None
Year:
2012
Region / City:
Cleveland, Ohio
Topic:
Legal advice and education
Document Type:
Volunteer Handbook
Organization:
Scranton Road Ministries C.D.C.
Author:
Not specified
Target Audience:
Volunteers and community members in need of legal guidance
Period of Action:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2015–2018
Region / City:
Scranton, Pennsylvania, USA
Subject:
Higher Education Employment Agreement
Document Type:
Collective Bargaining Agreement
Organization / Institution:
University of Scranton
Author:
Faculty Affairs Council and University Administration
Target Audience:
Full-time Faculty Members
Effective Date:
September 1, 2015
Expiration Date:
August 31, 2018
Includes:
Salary, Benefits, Teaching Assignments, Academic Calendars, Retirement Plans, Insurance, and Faculty Governance
Note:
Year
Region / City:
Scranton
Topic:
Ethics
Document Type:
Report
Organization / Institution:
City of Scranton
Target Audience:
City Officials and Employees
Year:
2019
Region / city:
N/A
Topic:
Telecommunications, IMT-2020
Document Type:
Technical Report
Organization:
ITU
Author:
Working Party 5D
Target Audience:
ITU members, telecommunications professionals
Period of validity:
N/A
Approval Date:
16 December 2019
Modification Date:
N/A
Note:
Year
Subject:
Sports injuries, Concussions
Document Type:
Acknowledgement Form
Target Audience:
Athletes, parents, sports organizations
Year:
2023
Region / City:
Ontario
Topic:
Secured lending agreements
Document Type:
Agreement
Organization / Institution:
Independent Electricity System Operator (IESO)
Author:
Not specified
Target Audience:
Secured lenders, suppliers, and the sponsor
Effective Period:
From the Effective Time onward
Approval Date:
Not specified
Amendment Date:
Not specified
Note:
Year
Topic:
Health care, medication administration
Document type:
Agreement
Jurisdiction:
Commonwealth of Massachusetts
Regulatory reference:
105 CMR 430.160
Document type:
Acknowledgement form
Subject area:
Camp health services and medication administration
Role defined:
Health Care Consultant
Medical license types referenced:
Physician, Physician Assistant, Nurse Practitioner
Authorized activity:
Administration of prescription medications to campers
Conditions of administration:
Parental or guardian written permission required; medications delivered to and maintained by the camp
Oversight:
Professional oversight by the Health Care Consultant
Signatories:
Health Care Consultant
Applicable setting:
Camp
Source type:
Administrative compliance record
Year:
2016
Region / City:
Norfolk
Subject:
Emergency Solutions Grant (ESG)
Document Type:
Questionnaire and Acknowledgement
Organization:
City of Norfolk’s Department of Neighborhood Development
Target Audience:
ESG sub-recipients
Effective Period:
2015-2016 program year
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2021
Region / city:
-
Subject:
Property rights, mortgage release, right of way acquisition
Document type:
Acknowledgement form
Organization / institution:
Wisconsin Department of Transportation (WisDOT)
Author:
-
Target audience:
Property owners involved in right of way acquisitions
Period of validity:
-
Approval date:
-
Date of amendments:
-
Document title:
QD83 – Global Supplier Quality Directive
Edition:
2018
Document type:
Supplier acknowledgement and acceptance form
Issuing organization:
ZF Friedrichshafen AG
Applicable standard:
QD83
Related documents:
QD83-2018 Sanctioned Interpretations
Scope of applicability:
All current and future supplies to ZF Friedrichshafen AG and affiliated companies within the ZF Group
Target audience:
Suppliers of ZF Friedrichshafen AG
Legal reference:
German Stock Law §§ 15
Replacement clause:
Replaces all previous agreements on ZF Supplier Quality Directives
Exclusions:
Specific quality assurance agreements remain unaffected
Geographic scope:
Global
Language:
English
Year:
2026
Region / City:
Marquette, MI
Subject:
Forensic Science, Ethics, Safety
Document Type:
Policy
Institution:
Northern Michigan University
Author:
Center for Forensic Science
Target Audience:
NMU students, faculty, staff, and visitors to the CFS sites
Period of Validity:
Ongoing
Approval Date:
N/A
Date of Changes:
N/A
Note:
Year
Region / City:
Alberta
Theme:
Property rights, land access
Document type:
Consent form
Target audience:
Landowners, contractors
Year:
Not specified
Region / City:
Not specified
Subject:
Risk acknowledgment for participation in activities
Document type:
Agreement
Organization / Institution:
Not specified
Author:
Not specified
Target audience:
Participants in the activity
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2021
Region / City:
British Columbia, Abbotsford
Theme:
Employment Policies, Church Employment
Document Type:
Employee Handbook
Organization / Institution:
Seventh-day Adventist Church (British Columbia Conference)
Author:
Seventh-day Adventist Church (British Columbia Conference)
Target Audience:
Full-time Education Employees
Period of Validity:
Ongoing
Approval Date:
March 2021
Modification Date:
Not specified
Year:
2016
Region / City:
Johannesburg
Subject:
Debt Acknowledgement
Document Type:
Legal Agreement
Institution:
University of the Witwatersrand
Author:
N/A
Target Audience:
Students of the University
Effective Date:
1 January 2016
Date of Signature:
Not specified
Date of Changes:
Not specified
Year:
2018
Region / City:
Wisconsin
Theme:
Health care, Medicaid
Document type:
Acknowledgment form
Organization:
Department of Health Services, Division of Medicaid Services
Author:
Not specified
Target Audience:
IRIS program participants
Period of validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2024
Region / city:
Southern New Hampshire University
Subject:
ADHD, Attention Disorders, School Programs
Document Type:
Program Overview
Organization / Institution:
Southern New Hampshire University
Author:
Michaela Carroll
Target Audience:
School-age children with attention disorders, educators, parents, clinicians
Period of Action:
June 16, 2024
Approval Date:
June 16, 2024
Modification Date:
N/A
Note:
Context