Mentor Application and Checklist


Contact Information


Last Name

First Name

Preferred Name

Street Address

City

State

Zip Code

Phone Number


Best Time To Call


E-Mail Address



Educational Background

Name of Law School

Location of Law School

Day or Evening Student

Part-time or Full-time

Year Graduated


Professional Background

Currently Employed (Y/N)

Employer’s Name

Position

Employment Sector
(i.e. Firm, Corporate, Government etc.)

General Substantive Area
(i.e. Civil, Criminal, etc.)

Total Number of Years Practicing Law

Professional Affiliations

Areas of Practice 

Please identify the employment sectors in which you have practiced.  (Check as many boxes as necessary)

Sole Practitioner

Private Practice

Litigation

Transactional

Political

Public Law

Advocacy

Policy

Judicial Clerkship

Corporate/In House Counsel

Non-legal field

Academia

Other

Additional Education (masters, doctorate, etc.)

Availability

During which days and hours are you available for meetings or conference calls?

Select all that apply (Hold CTRL and left click to select multiple times per day):

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:
Sunday:

Please indicate the best way to communicate with you: 


Agreement and Signature

I agree to participate in the Mentoring Program administered by the Young Lawyers Division
and agree to follow the roles and responsibilities of the Mentee.


By submitting this form and entering my initials below, I certify that the statements above are true, and the essay I am submitting is my own.
Your Digital Signature: