Jacksonville Bar Association -- Member Info >>Registration For Mentor Program

Areas of law in which you are requesting a mentor:
________________________________________________________________
________________________________________________________________

To the extent possible, you will be matched with a mentor who possesses the attributes identified in the following preferences. Please indicate your preferences:

1.	areas of substantive and procedural law and practice management ________________________________________________ ________________________________________________

2.	the mentor's type and size of practice ________________________________________________ ________________________________________________

3.	geographical location of mentor's practice ________________________________________________ ________________________________________________

4.	other requests or specifications for mentor ________________________________________________ ________________________________________________

I certify that I am currently a member in good standing of the Florida Bar or am awaiting results of my Florida Bar Examination and character and fitness inquiry by the Florida Bar.

Signature_____________________________________________Date_____________________

Please mail or fax this form and the attached waiver to:

Mentor Program Committee, c/o The Jacksonville Bar Association
841 Prudential Drive, Suite 1320
Jacksonville, Florida 32207
(Phone: 904-399-4486; Fax: 904-399-4854).

The Mentor Program is designed to provide attorneys within the Fourth Judicial Circuit and The Jacksonville Bar Association with the opportunity to heighten the degree of civility, professionalism and competence with which to represent their clients by creating an avenue for inexperienced attorneys to learn from more experienced attorneys. Any attorney who practices within the Fourth Judicial Circuit, whether newly admitted or an experienced practitioner, may use the Program.

I, as the mentee, shall contact the mentor and pose my question in the form of a "fact pattern" to avoid divulging the client's identity and to avoid any potential conflict of interest.

I agree and understand that the mentor will not be expected to do any legal research, review documents or pleadings, and that the mentor accepts no professional responsibility for any advice given. I shall make a professional evaluation of all advice received from the mentor and shall advise my client based solely upon my professional opinion, research and evaluation. In no case shall the mentor be liable for the advice provided.

I understand that any disclosure of the specifics of the problem or situation of my client may involve attorney client privilege. Neither the Mentor Program nor the mentors assume any liability or responsibility with respect to the response to an inquiry made pursuant to the Mentor Program. The Mentor Program does not contemplate a mentor rendering professional service to my client and I must ultimately exercise my own independent professional judgment on behalf of my client.

The Fourth Judicial Circuit Professionalism Committee is sponsoring and administering the Mentor Program, together with the mentor attorneys, and is merely rendering a benefit to the legal profession generally. Use of the Mentor Program is governed by the above conditions. Please contact The Jacksonville Bar Association at (904) 399-4486 regarding questions about the Mentor Program. The Jacksonville Bar Association will direct you to the appropriate individual to answer your questions.

I hereby certify that I have read and understand the waiver and agree to comply with the above information as set forth.

Signature:________________________________ Date:________________________

Print Name:_______________________________