Washtenaw Expungement Fair Intake

To register for a clinic with Michigan Advocacy Program/Legal Service of South Central Michigan’s Pro Bono Program please complete this online form. This may take you 5 to 10 minutes.

To apply online:

You will need a phone number or email address where we can safely reach you, and
You must live in Washtenaw county or have a criminal conviction in this county (note that if your conviction is out of our 13-county service area, we may be limited in the services we can offer to you).

If you are a resident of another county served by our Program (i.e.. Ingham, Eaton, Clinton, Livingston, Shiawassee, Barry, Branch, Calhoun, Lenawee, Monroe, or Hillsdale) or have a conviction in another county served by our Program, you are not eligible to attend the clinic, but we still may be able to help you! Please fill out the online intake form at https://map.tfaforms.net/26.

After you submit your application, we will review it. If you meet the requirements for our clinic, we will email you with a confirmation that you are eligible to attend the clinic, which will be held in person at the Washtenaw County Learning Resource Center (4135 Washtenaw Ave, Ann Arbor, MI 48108 ) on Saturday October 19, 2023 from 12 pm to 4 pm. If you have any questions please contact Caroline Laman, Pro Bono Coordinator at claman@lsscm.org

We care about your safety and privacy.

This is a secure website. But if you are using a public or shared computer, close the Internet browser when you are done. If you don’t, you might accidentally share your personal information with someone else.

Please let us know that you understand these concerns and want to continue.

I understand, agree, and want to continue.

YesNo

This is an application for legal help. We do our best to help everyone in Michigan who has a low income, but we may not be able to take your case because there are more people who need our services than we can help. Filling out this application does not guarantee you will get a lawyer.

Do you understand that completing this application does not guarantee that you will get help, and does not create an attorney-client relationship with Michigan Advocacy Program, Legal Services of South Central Michigan or any partner programs for the clinics?

I understand and want to continue.

YesNo

Authorization to continue

If you are concerned about either your privacy or your safety, and have decided not to use our online intake application. Please contact Caroline Laman, Pro Bono Coordinator at claman@lsscm.org instead. If you change your mind and want to finish applying for help online, you must agree to continue by clicking Yes above.

Authorization to continue

We're sorry, you cannot continue unless you understand and agree to the terms of use.

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Best time to contact you

We'll be calling you to talk more about your legal problem. When is it best for us to call you?

Contact via email

We generally communicate with our clients about their legal problems through email. Can we communicate with you via email?

Yes, I will check my email for communication about my case.No, I do not use email.

Please provide an alternate method for us to communicate with you:

PhoneTextUSPS Mail

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Address

Street

City

State

Zip Code

County

Is it safe to send you mail to this address?

Yes
No

Is the mailing address the same as above?

YesNo

Mailing Address

My mailing address is a post office box

Street

City

State

Zip Code

County

What best describes where you are living?

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Is someone helping you with this application, such as a social worker, neighbor, or relative?

Yes
No

Permission to Refer

Helper, do you have the client (friend, neighbor, or relative)'s permission to refer their case to MAP, LSSCM or any partner programs for the clinics?

YesNo

Helper's Contact Information

First Name

Initial

Last Name

Suffix

Agency

Phone

Helper's Email

If we cannot reach the client, can we contact you?

Yes
No

Helper Authorization

You can NOT complete this form without getting the client (friend, neighbor, or relative)'s permission. This permission is necessary because without it MAP, LSSCM or any partner programs for the clinics will not be able to reach out to the client and offer assistance. Correct your answer above after you get the permission.

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Adults

How many adults live in your household?

Count people 18 and over, including yourself if you are an adult. If you need help getting separated from someone who lives with you, don’t count that person.

Children

How many children live in your household?

Count people under 18, including yourself if you are under 18.

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You must qualify for our services to get help. For this question, we need information about income for every person in your household, except for someone who is the opposing party (such as someone you’re separating from or divorcing). Please include everything: income from work, child support you receive, and benefits like unemployment, Social Security, and cash assistance (FIP). Do not include Food Stamps (FAP) here. Pick an income type to submit information about every kind of income that is brought into your household (except for the opposing party’s income). When we talk to you, we will also ask a few questions about your household assets - things like bank accounts, vehicles, and real estate that you own.

For each source of income, select a type, frequency, and amount. If you don't have any income, count incomes for other people in your household. If no one in your household has income, select "No Income".

Your primary income

Income Type

Describe other

Frequency: when are you paid?

Amount

$

Income From Other Household Members

Income Type

Describe other

Frequency: when are you paid?

Amount

$

Do you or your household have any additional income?

Yes

No

Remember to include income from every person in your household except for the opposing party

Include income from every person in your household except for the opposing party

Income Type

Describe other

Frequency: when are you/they paid?

Amount

$

Do you receive food stamps?

YesNo

Amount

$

Do you expect your household income to change in the near future?

No, my/our income is NOT likely to change in the near futureYes, my/our income is likely to go UP in the near futureYes, my/our income is likely to go DOWN in the near future

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We know you are seeking help expunging your criminal record. How will an expungement help you going forward in your life? (600 characters max)

Other Legal Problem (600 characters max)

If you have any other legal problems, please quickly mention them here. We will ask you about it when when we talk to you. Do not submit another application.

By clicking "submit" you send your application to Michigan Advocacy Program and Legal Services of South Central Michigan for registration at our October 19 Expungement Clinic.