Pro bono Registration InstructionsThis form is used to register a Senior Client on our system.Capacity*Are you accessing this form for yourself or on behalf of another person? Please select the most appropriate below:I am registered as a Volunteer or otherwise registered with youI am seeking assistance for a friend or family memberI am seeking assistance for myselfClient Name First Last Previous assistanceHas the Client previously sought assistance from us? YesNoConrad Law Client?Has the client been a paid client of Conrad Law in the past?YesNoUserPlease look up the Client's registration. If you find them listed, do not submit this form and instead go straight to the Seniors Volunteer Workflow Form and use the Client's login for that form.@liquaforceAllen PayetConrad LawDavid MorganteGraeme SmithJan MarleyJohn FlemingLily ConradMike Maxwellpaul bruceRoy ThomasSTEVEN SAYCETest UserTest UserTiffany ShippTiffany ShippVickiClient detailsComplete the Client's details, or if the Client is already registered on our system, check that the information we have on file for them remains correct or update any details as required. Please ensure you use use the contact details for the Senior Client. (If you wish to use this site both for yourself and on behalf of the Client, please create a separate log in). Seniors Volunteer Workflow Client email Client PhoneClient's preferred phone numberClient AddressWhat is the best contact address for the Client Street Address Address Line 2 Suburb / Town State Post Code Client IdentifierThis is a unique Client identifier we use to retrieve the Client's details. In order of preference, use: 1. the Client's email address; 2. the Client's mobile phone number; 3. the Client's landline number without spaces; or 4. the Clients surname followed by their first initial and date of birth in the format "SmithG01011901" (ie 1st Jan 1901)Client PasswordAssign a password for this Client's Registration, following the standard password convention. Enter Password Confirm Password
