ISBA’s Mentor Application for 2014 Eligibility to Participate in ISBA Mentoring Program: Mentors shall be registered on the Illinois ARDC Master Roll of Attorneys as active and in good standing; be admitted to practice law in Illinois for not less than six years; never have been suspended or disbarred from the practice of law in any state or jurisdiction and have no formal disciplinary complaint pending; be active ISBA members. If you meet the eligibility requirements and wish to participate in the mentoring program, please complete the Mentor Application form below. Thank-you for your interest in lawyer mentoring.Attorney Registration No:*First Name:*Last Name:*Street Address:*City:*State:*Zip:*Phone*Email:*Enter EmailConfirm EmailTwitter Handle:Facebook Address:LinkedIn Profile:Law School:*Employer:*1. Check all of the qualifications listed below that apply to you:I am registered on the Illinois ARDC Master Roll of Attorney as active and in good standing.I have been admitted to practice law in Illinois for not less than six years.I have never been suspended or disbarred from the practice of law in any state or jurisdiction and have no formal disciplinary complaint pending.I am an ISBA member.2. Indicate what prompted you to become a mentor (check all that apply):I believe that mentoring is a way of "giving back" to the profession.I have participated in a mentoring program before and am renewing my commitment.I was encouraged to be a mentor by a judge, court, or bar association.My employer encouraged or asked me to participate.A new lawyer asked me to be his/her mentor.I heard about the program and decided to apply on my own initiative.Other:3. Select up to five areas of practice which best describe your interests:*Admin/governmentalAntitrust litigationArbitration/mediationBankruptcyBusiness/commercialCriminalElderEmployment/labor lawEnvironmentalFamily/DomesticFederal practiceGeneral practiceGeneral litigationHealthImmigrationIntellectual propertyInternationalJuvenilePractice managementPersonal injury/property damageProbate/trust/estateReal estate/landlord tenantSocial securitySports/entertainmentTort/insuranceTaxationTrafficTrial WorkWorkers compOther: 4. Check preferences for your mentor's type, size, and location of practice.Type of Practice:Solo practiceOf counselLaw firmGovernment office/JudgeIn-House corporate counselNon-legal jobSize of firm/organization:1 lawyer2-9 lawyers10-39 lawyers40+ lawyersLocation of practice:Large urban areaMedium-sized citySmall city/Rural areaOther:5. Check any or all of the following skills which you possess:AppealsTechnologyLaw practice managementRegulatory board appearancesResearchAbility to discuss substance abuse and mental health issuesAbility to be a resource for involvement in bar activitiesAbility to be a resources for involvement in pro bono activitiesAbility to assist with assessing career pathsAbility to advise on balancing career and home lifeAbility to advise on running a successful solo practiceAbility to discuss handling law school debtOther:6. Please check the way that you would like to be matched to a new lawyer:Match me to a new lawyer whose preferences correspond to my practice and interests.Pair me with the following lawyer who wants to be my mentee and register to participate in the lawyer-to-lawyer mentoring program.First Name of Mentor:Last Name of Mentor:Mentor Email Address:Mentor Phone:7. Additional requests or preferences?By submitting this registration form, I confirm that I will participate in the Lawyer-to-Lawyer Mentoring Program, if ISBA is able to match me to a mentee and I acknowledge that I will be awarded professional responsibility continuing legal education credit only when all program requirements are completed. CommentsThis field is for validation purposes and should be left unchanged.