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UCS-870 Rev. 10/11 APPLICATION FOR APPOINTMENT PURSUANTTO PART 36 OF THE RULES OF THE CHIEF JUDGETHIS IS AN ON-LINE APPLICATION. THE DATA YOU ENTER IN ITEMS 1-14 BELOW WILL BE TRANSFERRED ELECTRONICALLY TO THE OFFICE OF COURT ADMINISTRATION , BUT TO COMPLETE THE APPLICATION PROCESS, YOU MUST PRINT AND SIGN THE FORM AND MAIL IT TO OCA ALONG WITH ANY ATTACHMENTS. PLEASE FOLLOW THE SPECIFIC PRINTING INSTRUCTIONS INCLUDED IN THE ON-LINE SUCCESS MESSAGE YOU WILL RECEIVE AFTER PRESSING CONTINUE FOLLOWING ITEM 15. NOTE: BEFORE YOU COMPLETE THE APPLICATION, PLEASE CLICK HERE TO READ THE AFFIRMATION (ITEM 15) TO DETERMINE IF YOU ARE QUALIFIED.1. Name (If NYS Attorney, enter name used for Attorney Registration ) 7-A. Categories of appointment for which certified training is required:(no application for these categories will be processed unless the required training has been completed)• Choose the category or categories of appointment for which you are applying by checking the box next to the category.• Enter the year of the certified training program for which you received a certificate of satisfactory completion (For applications after June 1, 2003, training must not be more than two years before the date this application is submitted) . • Enter the full name of the organization that sponsored the training program (e.g., the name of a bar association, law school, nonprofit social agency, Surrogate's Court guardian ad litem training program or Appellate Division law guardian training program).• Attorneys applying for appointment as guardian ad litem, law guardian (privately paid) and attorney for alleged incapacitated person must be current in their registration to practice law in New York State (see item 4).• Indicate the number of times you served in the last 10 years for each category for which you are applying for appointment.• You MAY also attach a resume of NO MORE THAN FOUR PAGES.a. Guardian: Year certified training completed Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times b. Guardian ad litem: Year certified training completed Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times c. Law Guardian (privately paid)*: Year certified training completed * FOR APPOINTMENTS IN THE DEPARTMENTS OF THE APPELLATE DIVISION WHERE AUTHORIZED. (Approval for placement on this list must be obtained from the Appellate Division. See INSTRUCTIONS) Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times d. Court Evaluator: Year certified training completed Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times e. Attorney for alleged incapacitated person: Year certified training completed Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times f. Court Examiner: Year certified training completed (Approval for placement on this list must be obtained from the Appellate Division. See Instructions)Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times g. Supplemental needs trustee: Year certified training completed Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times h. Receiver: Year certified training completed Full name of sponsor organization:Frequency of service in the last 10 years: none 1-10 times more than 10 times 7-B. Categories of appointment for which certified training is not required:• Choose the category or categories of appointment for which you are applying by checking the box next to the category.• In order to apply in the following categories, you MUST attach a resume of NO MORE THAN FOUR PAGES, which shall include information of government-issued licenses and certificates issued by professional schools or organizations. • Attorneys applying for appointment as counsel to guardian or counsel to receiver must be current in their registration to practice law in New York State (see item 4). • Indicate the number of times you served in the last ten years for each category for which you are applying for appointment.i. Counsel to Receiver:Frequency of service in the last 10 years: none 1-10 times more than 10 times
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