Mentor Application
Name: Phone:
Email: I prefer to be contacted by: Phone Email
About You
Information in this section will be used to create an individual mentor profile that will be used to pair you with a mentee. Information may also be used for statistical and evaluative purposes.
Undergraduate school: Year of Graduation:
Major/Minor:
Law School: Year of Graduation:
Bar Related Activities:
Civic Activities:
Hobbies & Interests:
Additional Relevant Information:
What prompted you to become a mentor?
Please select three areas which best describe your practice:
Admin/governmental Intellectual Property
Antitrust Litigation International
Arbitration/Mediation Juvenile
Bankruptcy Practice Management
Business/Commercial Personal Injury/Property Damage
Criminal Probate/Trust/Estate
Elder Real Estate/Landlord Tenant
Employment/Labor Law Social Security
Environmental Sports/Entertainment
Family/Domestic Tort and Insurance
Federal Practice Taxation
General Practice Traffic
General Litigation Trial Work
Health Workers Comp.
Immigration Other:
Check those which apply to your employment:
Type of Practice: Size of firm:
Solo Practice 1 Lawyer
Of Counsel 2‐9 Lawyers
Law Firm 10‐39 Lawyers
Government office/Judge 40+ Lawyers
Non‐legal job
Other:
Acknowledgement
I do hereby certify that I meet all of the following minimum qualifications:
- (i)
Active Status. I am an active member of the Milwaukee Bar Association; and,
- (ii)
5 Years of Practice. I have been admitted to practice law for no less than five years ; and,
- (iii)
Professional Reputation. I maintain a professional reputation in my local community for competence, ethical and professional conduct; and,
- (iv)
Disciplinary Action. I have never received the sanction of disbarment or suspension from the practice of law in any jurisdiction, nor have I voluntarily surrendered my license to practice law for the purpose of disposing with a pending disciplinary proceeding in any jurisdiction. I am in good standing with the Office of Lawyer Regulation.
- (v)
Rules and Regulations. I have read and understand the rules and regulations of the Milwaukee Bar Association’s mentoring program
Signed: Date:
You may return this form via email or postal mail:
Milwaukee Bar Association
Attn: Mentoring Program
424 E. Wells St.
Milwaukee, WI 53202