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* 1. Name:

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* 2. Email: 

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* 3. What year did you graduate from the University at Buffalo School of Law?

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* 4. What was the name of the Clinic you participated in?

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* 5. Where are you currently working? (City & State)

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* 6. Does your employment involve assisting survivors of domestic violence?

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* 7. What is your profession?

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* 8. Do you volunteer or assist survivors of domestic violence outside of your employment?

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* 9. Favorite memory of the clinic:

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* 10. Information in this survey is being collected for the purposes of being presented at the 30th anniversary celebration of the Family Violence and Women’s Rights Clinic.

Do you consent to the information provided in this survey being used during the presentation? Information contained in this survey may be released to Darian Wilkom (Conference Committee Member) for the purpose of organizing the information in the survey and preparing the presentation.

(Name and contact information will not be disclosed in the presentation.)

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