Intake Questionnaire | Technology Law Clinic

Please note that only currently-enrolled students at Boston University or the Massachusetts Institute of Technology are eligible for representation by the BU/MIT Technology Law Clinic. If you or a central member of your organization are not a currently-enrolled student at BU or MIT, please do not fill out this form.

This is the intake form for the Technology Law Clinic, formerly known as the Technology & Cyberlaw Clinic. To fill out the intake form for the Startup Law Clinic, visit here. If you’re not sure which clinic is appropriate for your issue, fill out this questionnaire and we will help you find the proper help.

If you would prefer to send an encrypted message to the Clinic, please email Clinic Director Andrew Sellars directly, using his PGP Public Key.

University Affiliation

NOTE: Only currently-enrolled students at BU or MIT are eligible for representation by the Clinic.

University*

If you are requesting help on behalf of a team please use the university affiliation of the primary contact for the team.

Grade Level*

Please describe your grade level. Please note that only currently-enrolled students are eligible for the services of the clinic.*

Course / Department / Major

Client Infomation

Name of Client*

If you are requesting help on behalf of a corporate entity please use the entity's full legal name.

Primary Contact

Name*

First Last

Address

Street Address Address Line 2 City State ZIP Code

Personal/Venture Email*

Phone

Legal Question

Briefly describe your legal problem(s)/concern(s). Do not disclose any information you believe to be confidential.*

How did you hear about the Technology Law Clinic?

Disclaimers

The purpose of this form is to gather initial information to assess whether the BU/MIT Technology Law Clinic (the “Clinic”) is able to represent you in your matter and whether there exist any potential conflicts-of-interests.

Communication via the internet or this form does not establish an attorney-client-relationship; nor does it guarantee that Clinic or any of its constituents will be able to represent you in this or any other matter.

You are under no obligation to retain the services of the Clinic or any attorney(s) referred to you by the Clinic. You can always obtain counsel from any other source.

If the Clinic refers you to another attorney, you will be represented by that attorney, and not the Clinic. The Clinic makes no guarantees about the nature of legal assistance that attorney may provide.

PLEASE CHECK BOX BELOW INDICATING THAT YOU HAVE READ AND UNDERSTAND ALL OF THE DISCLAIMERS ABOVE.*

Yes