Application Form

Applicant Details


Application No*:	(to be alloted by DHCLSC)	Photograph file size not more than 50 KB
Application for empanelment of : (Please check in one column as an applicant can apply for only one panel).
Criminal Panel-1
Criminal Panel-2
Matrimonial Panel
Labour Panel
Civil Panel
Jail Visiting Panel

Mediator Panel
1. Applicant's Name* : (In Block Letters)
2. Father's/Husband's Name* : (In Block Letters)
3. Date of Birth(DD/MM/YYYY)* :
4. Age* : (as on 31st January, 2021)
5. Residence Address* :
6. Office/Chamber Address* :
Telephone No.(R)* :
Telephone No.(O) * :
Mobile No.* :
Email * :
7. Enrolment No.* :
Date of Enrolment * :
8. Actual Practice Experience * :
(Duration of actual practice in the Courts as on 31.01.2021)
9. Specify experience in :
High Court of Delhi/ Supreme Court of India* :
District Court/ Lobour Courts/ MACT/ any other Fora*:
10. Specify whether ever remained on the panel of the Delhi High Court Legal Services Committee or Delhi State Legal Services Authority, If yes, give details :

11. Whether any disciplinary case/ complaint is pending against the applicant with any bar Council/ Authority or any criminal case is pending or has ever resigned/ removed from the panel of DHCLSC/ DSLSA.If yes, give details :

List of the documents to be attached

1.	Self attested copy of Degree of Law.			Maximum file size 3 MB
2.	Self attested copy of Certificate of Enrolment.			Maximum file size 3 MB
3.	Self attested copy of Experience Cerificate issued by the Bar Association/ Council.			Maximum file size 3 MB
4.	In case for applying for Mediator Panel, attach copy of 40 hours mediation training certificate.			Maximum file size 3 MB
5.	In case applying for Criminal-I, Criminal-II, Matrimonial Panel, Labour Panel and Civil Panel, attach copies of atleast 02(two) orders/ judgements (passed by High Court of Delhi) wherein they have argued the case independently.			Maximum file size 5 MB Maximum file size 5 MB

DECLARATION

	I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief.In the event of any information being found false / incorrect at any stage, my candidature shall be liable to be rejected.I have read and understood the intructions and term and conditions of the empanelment and agree to abide by them.I declare that I fulfill the eligibility conditions for the category to which I am seeking empanelment.I am submitting only one application for empanelment.
	Place:
	Date :				Maximum file size 50 KB (Upload Signature of the Applicant)