| Section I. Basic Information |
| *Name: |
* Please enter your name. |
| *What are your pronouns? This helps us understand the best way to address you: |
* Please enter your Pronouns. |
| *State Bar of Wisconsin ID: |
* Please enter your member ID. |
| *Current Employer: |
* Please enter your current employer. |
| *Address 1: |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for your address 1 . |
| Address 2: |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for your address 2. |
| *City: |
* Please enter your city. |
| *State: |
* Please select your state. |
| *Zip: |
* Please enter your zip code in this format xxxxx or xxxxx-xxxx. |
| *County: |
* Please enter your County. |
| *Phone: |
* Please enter your 10-digit work phone number in format (XXX-XXX-XXXX). |
| *Email Address: |
* Please enter your email address in this format: youremail@example.com. |
Check here if we may use e-mail as our primary means of communication with you. |
| Other jurisdictions where you are licensed: |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for NeedsDesiresPrioritize. |
| Section II. Career Involvement |
| *What are your practice area(s)/desired practice area(s)? |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for Practice Areas. |
| *How many years have you been practicing? |
* Please enter only XX numbers for Years Of Practice. |
| Section III. Program Needs/Desires |
| *Why do you want to be a part of the Ready.Set.Practice. Mentor Program? |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for Reason of being part of the program. |
| *What are your career goals and how does this program fit into achieving those goals? |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for Career Goals. |
| What are you looking for in a mentor? While we will certainly take your priorities into consideration, we may also recommend a mentor that we feel would be a good fit that may not fit your criteria provided. |
* Please enter only valid characters [a-zA-Z0-9'.,?!\-#(); ] for Characteristics Desired. |
| I have malpractice insurance |
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Please carefully read the following requirements to be a mentee and the limitations of the Ready.Set.Practice. Mentoring Program: - The following may participate as Mentees:
- Wisconsin licensed, active lawyers, who are living and practicing in the state of Wisconsin.
- If a lawyer serves as a judicial law clerk immediately following licensure, the lawyer may participate in the Ready.Set.Practice. Mentoring Program within two years of completing the clerkship(s). A lawyer serving as a judicial law clerk is not precluded from participating in a mentoring program while a judicial law clerk, although due to ethical restrictions, the law clerk’s mentor must be a judge on the same court as the law clerk’s judge.
- The Ready.Set.Practice. Mentor Program is a professional relationship. It does not contemplate and is not intended to create a formal association or attorney-client or work product relationship between the Mentee and the Mentor. Similarly, for Mentors and Mentees not of the same law firms or office, the Mentor program does not create an attorney-client relationship between the Mentor and the Mentee’s clients; Mentees must ultimately exercise their own independent professional judgment on behalf of their clients.
- Mentee agrees to participate in a training session to be familiar with all of the ethical implications involved with participating in the Ready.Set.Practice. Mentor Program. The training session will be available by webcast for convenience. Details will be provided to Mentee upon selection into the program.
By submitting this form I certify that I have read the foregoing requirements and limitations. I agree to and understand the terms, and I qualify to be a Mentee. |
