Application For Admission To The Wyoming State Bar Page 4

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Clerk of the Wyoming Supreme Court
Supreme Court Building
2301 Capitol Avenue
Cheyenne, WY 82001
(307) 777-7316
Authorization and Release
(to be completed by all applicants)
I, _________________________________________________ , born on _______________________________________ (date)
in _________________________________________________ (city, state, country), having fi led an application for admission to
the Wyoming State Bar, hereby apply for a character report and consent to have an investigation made as to my moral
character, professional reputation and fi tness for the practice of law and such other information as may be received, all
of which will be reported only to the admitting authority. I agree to give any further information which may be required
regarding my past record. I understand that I will not receive and am not entitled to copies of the character and fi tness
report or reference forms, or to know their contents, and I further understand that the contents of my application are
confi dential with the exceptions as noted in the Rules and Procedures Governing Admission to the Practice of Law.
I also authorize and request every person, fi rm, company, corporation, educational institution (including law school), cred-
itor, consumer credit reporting service, governmental agency, court, association or institution having control of any docu-
ments, records and other information, including documents, records, bar association fi les regarding charges or complaints
fi led against me including all complaints erased by law, formal or informal, pending or closed, or any other pertinent data,
to permit the Wyoming State Board of Law Examiners or any of its agents or representatives to inspect and make copies
of such documents, records and other information. The records, however, will not include any information with respect
to a juvenile offense. I authorize the Wyoming State Board of Law Examiners or any of their agents or representatives to
obtain credit reports and further documentation relating to the same. I further authorize the Wyoming State Board of Law
Examiners to release information pertaining to my application as necessary to conduct and complete its investigation. I
also authorize the release to my law school(s) and the National Conference of Bar Examiners my name and summary data,
including pass/fail data, regarding my performance on the Wyoming Bar Examination.
Persons performing offi cial duties under the provisions of this rule, including members of the Character and Fitness Com-
mittee, members of the Board of Law Examiners, the executive director and staff, and members of the Bar working under
the direction of the Board, shall be immune from personal liability for all conduct in the course of their offi cial duties.
Information provided to the Wyoming State Board of Law Examiners concerning the mental stability or ethical or moral
qualifi cations of an applicant shall be absolutely privileged and no lawsuit may be predicated thereon.
I have read the foregoing Application and this Authorization and Release and have answered all questions fully and
frankly. The answers are complete and true of my own knowledge.
STATE OF
___________________________ )
) ss.
COUNTY OF
___________________________ )
Signature of Applicant
Signed and sworn to before me this ________
day of _______________________
20 _______ .
Notary Public
My commission expires
____________________________ (affi x seal)
page 4

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