Law Office Externship Program Application Form for Mentor Attorneys

Law Office Externship Program
Application Form for Mentor Attorneys
Please fill out this application, save the completed pdf file with your full name as the file name, and then e-mail it to [email protected].
Name of Law Office/Organization: ________________________________________________________________________________
Office Website: _____________________________________________________________________________________________
Address: __________________________________________________________________________________________________
City: ______________________________________ State: _______________________ Zip: ______________________________
Mentor Attorney: _____________________________________________ Title: __________________________________________
Phone: ____________________________________ E-mail: _______________________ Fax: ______________________________
Year Admitted to Practice:______________________________________________________________________________________
Second Contact Person (optional): ____________________________________ Title: ______________________________________
Phone: ____________________________________ E-mail: _________________________________________________________
Organization Type (Please check):
Nonprofit
Corporation
Government Agency/Office
Private Firm
Substantive Areas of Practice (Please check):
Administrative
Domestic Violence
Gay/Lesbian Rights
Personal Injury
Alternate Dispute Resolution
Education
Health Law
Poverty Law
Antitrust
Elder Law
Immigration Law
Real Estate
Bankruptcy
Employment Law
Intellectual Property
Securities Law
Civil Rights
Entertainment Law
International
Tax Law
Consumer Law
Environmental Law
Labor Law
Other ________________
Corporate Law
Estates and Trusts
Legislative
Criminal Law
Family Law
Medical Malpractice
Please indicate the types of work the student externs will perform:
Case Preparation
Client Intake/Counseling
C ourt/Administrative
Proceedings
Fact Investigation
Negotiation
Research and Writing
Policy Work
Other ________________
Please select the semesters during which you are willing to work with student externs:
Fall
Spring
Summer
Required Documents:
Résumés Only
Résumés and Writing Samples
Please write a brief description of the work your law office performs and the learning opportunities you expect to have available
for law student externs:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Learn law. Take action.
Describe where your extern(s) will work (e.g., your office, library, other) and the work-station available to them:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Law Office Externship Program
Mentor Attorney Agreement
________________________ (name of law office/organization) has designated
________________________ (attorney’s name) to act as mentor attorney to New York Law School externship students placed in this office.
________________________ (attorney’s name) is authorized to enter into the program on behalf of the law office/organization, and the law
office/organization agrees to cooperate with the attorney mentor in fulfilling the responsibilities set forth herein;
the attorney mentor agrees to be responsible for the supervision and activities of the student externs placed in the law office/organization, and
to be accessible to the student externs and the Office of Career Planning and Student Life throughout the semester for discussion and follow-up
of the students’ activities and progress;
the attorney mentor agrees to integrate student externs as much as possible into all aspects of their practice and to give student externs a
variety of meaningful and educational work assignments designed to further the following program goals:
1. To promote the extern’s understanding of the roles of lawyers and their sense of professional responsibility.
2. To develop the extern’s ability to learn from experience.
in addition, the attorney mentor agrees to develop with each student extern a set of personal learning goals for the externship, and work with the
student to assure that such goals are being met;
the attorney mentor agrees to provide the student externs with feedback on the work, and provide written evaluations of their performance on
forms supplied by the Office of Career Planning and Student Life, and;
the law office/organization agrees not to bill for any work done by student externs.
I agree to the terms and conditions outlined above.
NON-DISCRIMINATION POLICY
Discrimination and harassment interfere with the educational purpose of New York Law School and negatively affect all members of the Law
School community. Faculty, staff, and students have a right to be free from discrimination and harassment based on race, color, ethnicity, ancestry, citizenship, religion, sex, pregnancy, sexual orientation, gender identity, gender expression, national origin, age, disability, AIDS, predisposing
genetic characteristics, marital or parental status, military status, domestic violence victim status, or any other classification protected by local,
state, or federal law (“Protected Classification”). Discrimination or harassment directed at any member of the Law School community within the
context of the Law School or Law School-sponsored activities will not be permitted, and complaints will be investigated promptly and thoroughly.
New York Law School is proud of its policy of maintaining a work, academic, and residential environment that encourages tolerance and respect
for the dignity of each individual.
I agree and abide by these non-discrimination principles.
Signature: ______________________________________________ Date: _____________________________________________
Office of Career Planning and Student Life
[email protected]
T: 212.431.2345
F: 212.274.1491