LSYWC Mentor Application

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

Gender

Employer Information

Are you currently employed?

Name of Current Employer

Title/Occupation

Years with Employer

Are You Currently Practicing Law?

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?

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

2026 APPLICATION FOR MENTORS