LSYWC Mentor Application

2025 APPLICATION FOR MENTORS
Basic Information
Legal Name*

First NameMiddle NameLast Name
Preferred Name
Preferred Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred E-Mail Address*
Preferred Telephone Number*
Race/Nationality*

American Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhiteOther
Gender*

Male (including transgender men)Female (including transgender women)Non-BinaryPrefer not to sayOther
Employer Information
Are you currently employed?*

YesNo
Name of Current Employer
Title/Occupation
Years with Employer
Are You Currently Practicing Law?*

YesNo
How many years have you practiced law?
In what area of law do you practice?
If Other, Please Specify
Academic
Law School Attended/ing*
City and State of Law School*
Year of Graduation / Anticipated Year of Graduation*
Mentor Questions
Are you able to commit at least a few hours per month to meet with your Fellow and attend an orienation and kick-off during the summer/fall?*

YesNo
Describe any preferences you might have regarding your potential Fellow (i.e. gender, race, interests, etc.)*

0/500
Describe your professional and relevant personal interests:

0/500
Describe prior mentoring experience, if any:

0/500
Describe why you are interested in mentoring and how you might personally benefit:*

0/500
Some of our Fellows have had to overcome challenges in their lives, such as the loss of a parent; discrimination on the basis of race, gender, or sexual orientation; or being required to take on an early care-taker role in a family. If you feel comfortable sharing, have you had similar life experiences or overcome similar challenges? Would this experience allow you to form a unique bond with your Fellow?

0/500
Other questions or comments:

0/500
May LSYWC use any of your above statements for our "Why I Mentor" marketing materials?*

YesNo
Should be Empty:

2025 APPLICATION FOR MENTORS