Brief Mentor Interest Form
Greetings!

The purpose of this form is to identify members of the Social Work and Law Symposium community interested in becoming a brief mentor to students and early career practitioners as part of our Bridge to Justice Brief Mentoring Program. During the annual symposium, students or early career practitioners are invited to participate in a 45-minute brief mentoring session with a seasoned professional. Those who seek mentorship through the Bridge to Justice Brief Mentoring Program may need career guidance or advice, problem-solving or decision-making support. Brief mentors are paired with students and/or early career practitioners that express interest in their area of practice and expertise. The brief mentor provides a one-time session of support that includes sharing resources as well as suggestions for identifying a more permanent mentor in their local area.

Brief mentors may be asked to engage with students expressing mentor help before and/or after the annual Social Work and Law Symposium.

The information outlined below is needed for all interested.
  • Name (include credentials)
  • Affiliation & title
  • Location
  • Email
  • Status (i.e., professional, faculty, etc.)
  • What is your reason for wanting to become a brief mentor?
  • What are your areas of specialization?
  • Are you available to meet with students BEFORE the Annual Social Work and Law Symposium?
  • Are you available to meet with students DURING the Annual Social Work and Law Symposium?
  • Are you available to meet with students AFTER the Annual Social Work and Law Symposium?
  • Will you require training to provide brief mentoring support?

Thanks for your interest. We look forward to you joining our efforts to provide brief mentoring to students.




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Name
(Include credentials)
*
Affiliation & Title
*
Location
(city and state)
*
Email address
*
Phone number
*
Status
*
Required
Current occupation
(include working title)
*
What is your reason for wanting to become a brief mentor?
*
What are your areas of specialization?
*
Are you available to meet with students BEFORE the annual Social Work and Law Symposium?
*
Required
Are you available to meet with students DURING the annual Social Work and Law Symposium?
*
Required
Are you available to meet with students AFTER the Annual Social Work and Law Symposium?
*
Required
Will you require training to provide brief mentoring support?
*
Required
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