FIRST NAME LAST NAME NAME PREFER TO BE CALLED CURRENT EMPLOYER (if applicable) ADDRESS LINE 1 ADDRESS LINE 2 CITY STATE ZIP WORK PHONE MOBILE PHONE HOME PHONE E-MAIL YEARS OF LEGAL PRACTICE LAW SCHOOL YEAR OF GRADUATION UNDERGRAD SCHOOL AND MAJOR Other Professional Degrees/Licenses/Ceritfications: Organizations for which you regularly volunteer and activities performed: DEMOGRAPHICS AND PROFESSIONAL INFORMATION GENDER FEMALE MALE AGE RANGE 21 - 29 30 - 39 40 - 49 50+ RACE White (not Hispanic Origin) Black (not Hispanic Origin) American Indian or Alaskan Native Asian or Pacific Islander Hispanic Other Please specify I choose not to disclose this information If you chose Other for race, please specify WORKPLACE Solo Practice (1 Attorney) Small Firm (2-5 Attorneys) Medium Firm (6-20 Attorneys) Large Firm (more than 21 Attorneys) Corporate Government/Courts Public Interest Law School/Legal Academia Non-Legal Practice (Please specify) Other (Please specify) If you chose Other for workplace, please specify PRIMARY AREA(S) OF PRACTICE Benefits Bankruptcy In-House Counsel Criminal Corporate (General) Corporate (Mergers & Acquisitions) Corporate (Securities) Corporate (Please specify) Environmental Family Law (Please specify) Finance (Please specify) General Practice Immigration Intellectual Property Labor & Employment Litigation (Construction Law) Litigation (Commercial Law) Litigation (Criminal Defense) Litigation (Please specify) Public Interest (Please specify) Real Estate Tax Trust & Estates Workers Compensation Other (Please specify) Primary Area of Practice Specifications List MCB Sections you belong to: Amount of time you are willing to commit to Linking Lawyers per month. 1 hour 2-3 hours 3-5 hours 5 + hours Have you ever opened your own office or created a new practice area in a firm? Yes No What types of office environments have you practiced law in different from your current workplace? (i.e. large/small firm, corporation, etc.) Have you ever been on a referral list or court appointed list? Yes No Please select a preference regarding the length of time your mentor has been practicing law: I prefer a mentee who has been practicing the same amount of time as me I prefer a mentee who has been practicing 0-5 years I prefer a mentee who has been practicing 5-10 years I prefer a mentee who has been practicing 10-15 years I prefer a mentee who has been practicing 15-20 years I prefer a mentee who has been practicing over 20 years No preference Would you prefer a mentee of the same or different gender as your own? Same Different No preference Would you prefer a mentee of the same or different race as your own? Same Different No preference Would you prefer a mentee in the same or different practice area as your own? Same Different No preference Would you prefer a mentee who works in a similar workplace as your own? (corporate, small firm, solo, etc.) Same Different No preference In lieu of receiving an individual mentee, would you be interested in a mentoring group? Yes No Please also list three non-law related skills that are important to the practice of law (i.e. marketing, IT, accounting skills, etc.) that you possess: With what areas of your experience are you willing to assist your mentee? Bar leadership Navigating the law firm culture Networking Opening a solo or small firm practice Resource on professionalism Transitioning between practice areas Volunteer opportunities Other (Please specify) If you chose Other, please specify Would you be willing to mentor an unemployed mentee? Yes No What are your expectations of mentees? What are your expectations of the Linking Lawyers program? What is your idea of a successful mentoring program? Please list any additional factors you would like us to consider when assigning your mentee: