Mentor Availability and Update Form

Name

First

Last

Bar Number#*

Email address*

Company Name:

Address:

Phone:

Available to mentor July 2019-June 2020:

Yes

No

I want to remain on the NLTP Approved Mentor List:

as an active member

as an inactive member

I want to be taken off the NLTP Approved Mentor List

PLEASE NOTE:

If you elect to be removed from the Approved Mentor List, you will need to re-apply to be a mentor if you should ever want to participate again. If you would like to remain on the approved mentor list, but do not want to actively participate, please choose the inactive mentor option above, and you will remain on the mentor list, but your name will not be released to new lawyers as an available mentor.