Name
*
First Name
Last Name
Phone
*
(###)
###
####
Mailing address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Pronouns
Law School / Year of (Expected) Graduation
Undergraduate School
Practice area or area of interest, volunteer work, student group participation, etc
Hobbies/Interests
What are your expectations of the mentoring relationship (e.g. networking, career development, etc.)?
Do you have any special requests regarding mentor (e.g., being paired with a mentor of a specific age, gender identity, practice area, activist interest, etc.)? If so, please describe:
Is there anything else you'd like to tell us about your involvement in the program (e.g. your goals in participating, suggestions for the program, etc.)?
Check the box that best applies to you:
*
In terms of contacting your mentor, check the box that best applies to you:
*
I authorize the release of this information to my mentor:
*
