JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
GACDL Mentor Application
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name:
Your answer
Mobile Phone:
Your answer
Office Phone:
Your answer
Office Address:
Your answer
Type of Practice:
Private Practice
Public Defense/Appointed Work
Both
Clear selection
Courthouses/Counties You Frequent:
Your answer
How long have you been practicing Criminal Law?
Your answer
Do you practice law anywhere other than Georgia?
Your answer
Have you ever been a mentor before? If so, explain:
Your answer
Why do you want to be a mentor?
Your answer
What is your availability (i.e. best time to communicate, meet with a mentee, go to court, etc.)?
Your answer
How involved are you looking to be with your mentee?
Your answer
Any additional information you'd like to provide that wasn't asked:
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of Peters Rubin & Sheffield, PA.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report