Minority Mentoring - Student Interest Form

Local Home Information

Permanent Home Information (If different from local)

Other Information

Please indicate city, state, and region

OPTIONAL: Please rank the categories below to help us in matching you with a mentor, with “1" being most preferred and “5" being least preferred:

(Example: If being matched with someone in a particular practice area is most important to you, you will place a “1" next to practice area.)

Please note that we will be our best to meet your preference specifications, but can not guarantee we will meet all of your requests.

Please tell us how you envision your mentoring relationship unfolding (how many contacts, what you would like to talk about or experience during personal visits, etc.), in order to assist the program committee and the mentor in understanding your needs at this time:

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