First Name *

Last Name *

Email *

City & County of Practice

City & County of Residence

Undergraduate Institution

Year of Graduation

Law School

Year of Law School Graduation

Bar Admission(s)-Include State(s) and Year(s) or Intended State(s)

Practice Area(s)/Intended Practice Area(s)

How many years have you practiced law?

I identify my gender as________ (If you prefer not to answer please state that in the box.)  *

Ethnicity (If you prefer not to answer please state that in the box.)  *

Are you a parent?

Yes

No

Prefer not to answer

First generation to attend law school?

Yes

No

Please describe your hobbies and general interests

What are some specific experiences or insight you want to share as a participant in this mentoring program?

What are some career experiences you wish to share with a potential mentee?

Do you have a plan to assess and achieve your expected goals for participating in this mentoring program?

What are the overall expectations you have from this mentoring program?

Suggested Discussion Topics (Check all that apply)

Interested in discussing topics related to business development and cultivating working business relationships

Interested in discussing topics related to a non-traditional legal career and trajectory

Interested in discussing topics related to gender and race bias in the legal community

Additional Considerations: I would prefer a mentee who...(Check all that apply)

Identifies as a woman

Identifies as a man

Identifies as LGBTQ+

Is ethnically diverse

Lives or works in the same city/county as I am

Is a parent

Is first generation to attend college/law school

No preference

I identify as... (Check all that apply)

Asian

African American

Caucasian

Hispanic/Latinx

Native American

Pacific Islander

Other

Prefer not to answer

As a mentor, I agree to commit designated hours per quarter to working with a mentee. I agree to permit the Diversity Committee of the NYSBA Business Law Section to use this information provided solely for the purpose of matching me with a mentee. *

I agree

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