Mentor Application Please complete this application to participate as a mentor in the Illinois State Bar Association Mentoring Program. 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 five 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 Email Confirm Email Twitter 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/governmental Antitrust litigation Arbitration/mediation Bankruptcy Business/commercial Criminal Elder Employment/labor law Environmental Family/Domestic Federal practice General practice General litigation Health Immigration Intellectual property International Juvenile Practice management Personal injury/property damage Probate/trust/estate Real estate/landlord tenant Social security Sports/entertainment Tort/insurance Taxation Traffic Trial Work Workers comp Other:4. Check the following for your type, size, and location of practice.Type of Practice: Solo practice Of counsel Law firm Government office/Judge In-House corporate counsel Non-legal job Size of firm/organization: 1 lawyer 2-9 lawyers 10-39 lawyers 40+ lawyers Location of practice: Large urban area Medium-sized city Small city/Rural area Other:5. Check any or all of the following skills which you possess: Appeals Technology Law practice management Regulatory board appearances Research Ability to discuss substance abuse and mental health issues Ability to be a resource for involvement in bar activities Ability to be a resources for involvement in pro bono activities Ability to assist with assessing career paths Ability to advise on balancing career and home life Ability to advise on running a successful solo practice Ability to discuss handling law school debt Other: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. (Enter mentee's information below) First Name of Mentee:Last Name of Mentee:Mentee Email Address: Mentee 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.NameThis field is for validation purposes and should be left unchanged.