American Bar Association Judicial Division
Judicial Mentoring Program

Attorney Questionnaire

Personal Information
Name:
Business Address:
City:
State/Province:
Zip/Postal Code:
Country:
E-mail Address:
Telephone Number:
Fax Number:

Optional Alternate information for secretary or law clerk
Name:
E-mail Address:
Telephone Number:
Fax Number:
Attorneys participating in the program will be matched with mentors by gender, ethnicity, disability and sexual orientation to the extent possible and desired. Identifying yourself in these categories will assist in the matching process.
Gender:
Sexual Orientation (optional):
Race/Ethnicity:
Disability (optional):
Law school graduation date:
State the date and courts of admission(s):
Describe the types of practice you have (identify any specialty):

American Bar Association Section or Division ABA ID#
Hispanic National Bar Association
National Asian Pacific American Bar Association
National Bar Association
National Native American Bar Association
National Lesbian and Gay Law Association
Other

Gender:

Ethnicity:

Disability (optional):

Sexual Orientation (optional):

Court Preference - not to exceed three. Please list one as highest priority and three as lowest:

Federal Trial

Federal Appellate

Federal Bankruptcy

Federal Trial Magistrate

Intermediate Appellate

State Trial

State Trial Appellate

State Administrative Law

Federal Administrative Law

Military

Tribal

Elected Appointed

How did you hear about the program?

If you have any questions regarding this form or the program, please contact Judge Leslie Miller at lmiller@sc.pima.gov.

Agreement Statement I agree that all the above information is accurate to my knowledge and that I am solely agreeing to be matched up with judges based on the information I provided above to participate in the Judicial Division Judicial Mentor Program. Enter today's Date (mm/dd/yyyy): Your information will only be used within the ABA and its entities. We do not sell or rent e-mail addresses to anyone outside the ABA. The Judicial Division Mentor Program is cosponsored by the ABA Young Lawyers Division.