College of Law | Mentoring Program

Title:

Mr.
Ms.
Mrs.
Dr.

First Name *

Middle Initial

Last Name *

Business Address *

Business Email Address *

Daytime Phone Number *

Alternate Phone Number

Fax Number

How would you prefer to be contacted? *

By phone
By email

Did you attend the University of Tennessee College of Law?

Yes
No

If not, from what law school did you graduate?

What year did you graduate from law school?

Please list any dual-degree programs in which you participated, if any.

Please list any student organizations or activities in which you participated while enrolled in law school.

Undergraduate Institution:

Degree:

Major:

Year of Graduation:

Other College / University:

Degree:

Field of Study:

Year of Graduation:

Please list your practice area(s).

I am willing to mentor:

one student
two students
more than two students

Can you suggest any other attorneys who might be interested in serving as mentors? Please provide contact information.

Do you have an interest in working with a specific group of students? If so, please specify.

Are you in good standing with your state bar association?

Please indicate whether or not you agree with the statements below.

I UNDERSTAND that I am responsible for printing and reading The Mentoring Program Handbook. *

Agree
Disagree

I AGREE to contact the Program Coordinator if I have any questions, comments, or concerns about the Mentoring Program, my mentee, or regarding a change in my abilities to serve as a mentor. *

Agree
Disagree

I CERTIFY that I am in good standing with my state’s bar association, or I certify that I am not required to have a license. *

Agree
Disagree

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