(CASE CAPTION)
I, ___________, am ____________________ , in the above entitled matter.
I have been requested by ____________, Esquire, an attorney duly admitted to practice in the State of Delaware to permit ____________, a student intern, to appear for me in this matter. I have been given a copy of Rule of the Supreme Court of the State of Delaware and it has been fully explained to me that _________, the student intern, is a third year law student who is not a member of the Bar. I hereby consent to representation by such student intern in this matter, and voluntarily and knowingly waive any right I may have to representation by a member of the Delaware Bar.
Dated:
STATE OF DELAWARE
COUNTY OF ________
________________, 20
______________________
Witnessed:
___________________
Supervising Attorney
(The original is to be filed in the Court record)
Del. R. Sup. Ct. Form I