Online InTake

Mid-Shore Pro Bono

499 Idlewild Avenue
Easton, MD 21601
(410) 690-8128
info@midshoreprobono.org

Please complete the form below with your personal and legal details. All fields must be completed.
Please note, MSPB does NOT handle Criminal Cases.

After you hit the submit button, an MSPB representative will call you to complete the screening process to determine if you are eligible for services.

Step 1 Personal Information

* Required Fields.

PreFix

First Name

Last Name

Address

City

State

Zip Code

Resident County

Phone

Note: Please use your most reliable / most used email address.

Education Level

Gender

Marital Status

Ethnicity

Age

Primary Language

Primary Language Other

Employer

Veteran

Income

Frequency

Family Size

Step 2 Legal Matter

Referred By

Referred By - Other

Case Type

Legal Matter Please provide details. Limit 500 Characters.

Characters Left: 500

Opposing Party

Opposing Party Contact Info

Relationship To You

Party To

Opposing Party Counsel

Court Case Number

Hearing Type

Hearing Date

Enter mm/dd/yyyy

Case County

Step 3 Additional Information

Do You Own Property?

List Property Owned

Do You Own Property

List Property Owned

Dependents

Enter your spouse/domestic partner and dependent children. If none, leave blank.

Relationship	Name	Age

I acknowledge that I am submitting information for intake and that additional documents and information will be required to complete my application for services.