Application for Legal Assistance Name(Required) First Last IEA/NEA Member? Yes No Type of Teaching Certificate Held: Address(Required) Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email - personal - NOT school(Required) School District Home Phone(Required)Years Employed or Teaching Years Teaching/Employed in Current District Date Application Submitted MM slash DD slash YYYY Date of Incident MM slash DD slash YYYY Summary of Problem: Please state explicitly the nature and extent of the problem. Give details in a sequential or chronological order.(Required)Resolution Sought:(Required)Upload any supporting documentation here Drop files here or Select files Accepted file types: pdf, doc, png, jpgaccepted, Max. file size: 50 MB. Consent(Required) I Agree 1. The applicant agrees that, before the IEA makes a decision whether to provide legal assistance in this matter, the IEA may conduct a full investigation of this matter, if the IEA so chooses. 2. If the IEA decides to provide legal assistance in this matter, in consideration for this assistance, the applicant agrees to comply with the provisions of the IEA Legal Services Guidelines, a copy of which is available for review and/or copying by the member at each IEA Region Office. In addition, the applicant agrees as follows: a. The IEA may employ an attorney of its choice to pursue this matter on behalf of the applicant. b. The applicant will fully cooperate with the IEA and the attorney employed by the IEA to pursue this matter. The applicant specifically consents to the release of information concerning this matter to the IEA by the attorney employed to pursue this matter and to the compensation of this attorney by the IEA. c. With regard to the handling of this matter, the applicant agrees to consult with the IEA, to accept the decision of the IEA, and to allow and direct the attorney employed by the IEA to pursue this matter consistent with the decision of the IEA. This shall include IEA decisions concerning the following: (i) the form in which any action is brought; (ii) the court in which any action is filed; (iii) the procedures used in pursuing the action; (iv) whether the action should be compromised and settled, and if so, the amount of settlement; (v) whether any adverse decision in the matter should be appealed, and if so, the manner in which the appeal should be pursued. If the applicant fails to consult with the IEA or to interact with the attorney in accordance with the agreement, the IEA may immediately withdraw its legal assistance in this matter. In that event, the applicant consents to the withdrawal of the attorney from any further representation of the applicant in this matter. d. From any amounts recovered in this matter by the applicant by way of judgment, settlement, or otherwise, to the extent that the amount recovered is in excess of the applicant’s actual losses (such as a recovery for double or triple damages or for punitive or exemplary damages) or if the applicant is awarded costs and/or attorney’s fees by a court or arbitrator or recovers costs and/or attorney’s fees in whole or in part from the educators employment liability insurance provided by the IEA, the applicant shall reimburse the IEA in an amount not to exceed the actual costs and attorney’s fees expended by the IEA. This completed form constitutes a written request for IEA assistance in dealing with the problem stated, and, if the IEA provides legal assistance to the applicant, a contract between the IEA and the applicant for the provision of legal services. Applicant Signature(Required) February 23, 2022 Share this post Share on FacebookShare on Facebook TweetShare on Twitter Share on LinkedInShare on LinkedIn Related posts34 Aspiring Educators Join IEA at U of I EventMay 13, 2022West Ada EA Holds Legislative Candidate ForumMay 6, 2022REGISTER NOW — 2022 Summer InstituteMay 6, 2022IEA Board Elections Begin TodayMay 6, 2022
