Fill and Sign the Application for a Temporary Volunteer License to Practice Form

1 PLEASE READ CAREFULLY Before you apply for a TEMPORARY PROTECTION ORDER, you, the Applicant, should be aware of the following: A. In order to apply for an Order for Protection Against Domestic Violence, you must be 18 years of age or older, the victim of a specific type of ACT, and you and the Adverse Party must have a specific type of RELATIONSHIP. Under NRS 33.018, the required act can include any of the following: 1. Battery (Any physical contact--hitting, pushing, shoving). 2. Assault (Threats to commit battery). 3. Compelling you by force or threat of force to perform an act from which you have the right to refrain or to refrain from an act which you have the right to perform. 4. Sexual assault. 5. A knowing, purposeful, or reckless course of conduct intended to harass you. Such conduct may include, but is not limited to: Stalking Arson Trespassing Injuring or killing an animal Larceny Destruction of private property Carrying a concealed weapon without a permit False imprisonment Unlawful entry or forcible entry into your residence B. Under NRS 33.018, the Adverse Party must commit the above act(s) against one of the following people:1. His spouse or former spouse; 2. Any other person to whom he is related by blood or marriage; 3. A person with whom he is or was actually residing; 4. A person with whom he has had or is having a dating relationship; 5. A person with whom he has a child in common; 6. The minor child of any of those persons; 7. His minor child; or 8. Any person who has been appointed the custodian or legal guardian for his minor child. C. When you fill out the Application, it is helpful to explain the relationship in detail. For example, state how long you have been married or divorced, how long you have been living together and/or when you separated, how long you have been dating and/or when the relationship ended, etc. D. By filling out this Application, you are giving a SWORN STATEMENT and asking the Court to intervene to protect you from the Adverse Party. E. A legal process is being started. Only a judge can stop this process. F. There are three possible rulings that the Court can make after you file the Application: (1) Grant the request for a Temporary Protection Order; (2) Require a hearing to clarify issues on the Application before granting or denying the request; (3) Deny the request. 2 YOU MAY HAVE TO APPEAR IN COURT IF : (1) Your request is granted and an Order is issued with a hearing date scheduled; or (2) A hearing is required before a decision can be made as to whether the Court will grant or deny the request. If the Adverse Party is served, he/she will receive a copy of the TEMPORARY PROTECTION ORDER or ORDER FOR HEARING and a complete copy of the APPLICATION, but will not receive a copy of the confidential information sheet. If the Adverse Party is served, he/she will be notified of any hearing and will have the right to attend. The hearing is your opportunity (and the Adverse Party’s opportunity) to speak to a judicial officer and request an extension, modification, correction, or dissolution of the Protection Order. Any Protection Order that is issued will require that the Adverse Party NOT have any contact with you. “No contact” restrictions may possibly have an effect on child visitation and child custody. GUIDELINES FOR COMPLETING THE APPLICATION (1) Use BLACK or DARK BLUE INK when filling out the Application. Pencil or different-colored ink is not acceptable. (2) Do NOT write on the back or along the sides of any pages. Use extra paper if necessary. Standard 8½ by 11-inch paper is preferred.(3) PRINT OR WRITE CLEARLY . (4) Identify ALL minor children that are LIVING IN your home. Include their dates of birth. (5) BE SPECIFIC. Get to the point and detail WHAT happened and WHEN it happened. It is best to start with the MOST RECENT incident(s) and to provide approximate dates. If the Adverse Party threatened you, list the exact language that was used. Do not be concerned about profanity. The Court needs to know exactly what was said. (6) Once this Application is filed, it becomes a matter of public record. If there are addresses or telephone numbers you do not want the Adverse Party to know, DO NOT put that information in the Application. Select the confidential box. (7) Please make every effort to provide a home or work address for the Adverse Party, so that he or she can be served or given notice of this Order. (8) If there is any part of this Application that you question or do not understand, leave the area blank until you meet with an advocate/court employee. (9) DO NOT SIGN the Application until you are with a court employee or an advocate. You may need to provide picture identification. (10) A Judicial Officer will review your Application to determine if a Protection Order Against Domestic Violence should be issued based upon your detailed description of events that requires court intervention. (11) Be advised that the Court cannot provide legal advice. If you need more information about your legal rights and remedies, you are encouraged to consult with an attorney.