Mentor Request: Application Form
All information provided on this form is strictly confidential and will ONLY be used for the purpose of checking eligibility and monitoring and evaluating the scheme. It will not be shared with anyone outside of this scheme.
Part A: Eligibility
(1)Please select one or more of the following backgrounds to show that you are eligible to participate in this scheme.
Please select as appropriate
Gender / FemaleEthnicity / Asian or Asian British
Black/African/Caribbean or Black British
Mixed/multiple ethnic backgrounds
Please specify if other:
Social background[1] / Attended a (non-fee paying) state school or college
Or,
Was the first generation in their family to attend university
(2)If you are seeking to apply for your first appointment, as a prerequisite to participating in the scheme, you must confirm that –
Please select
You have undertaken judicial work shadowing in the jurisdiction you are seeking a mentorhold a minimum of 7 years post qualification legal experience
are seeking to apply for a judicial appointment in the next two years (or at the next available opportunity)
Have you been subject of disciplinary findings with your professional body within the last three years?
No Yes If Yes, please specify
Do you have any conditions on your authority to practice (e.g. practicing certificate)?
No Yes If Yes, please specify
Please note that your request for a mentor will be declined if you have conditions on your authority or if you have been suspended from practice following a finding against you within the last three years.
If you are an existing Judicial Office Holder, please provide information relating to your current appointment(s) –
Name of appointment / Salaried / Fee-paid / Date of appointment (MM/YYYY)1
2
3
Part B: About you
Professional SurnameForename
Title
Professional Background
(Please put a cross against the relevant background and provide the month and year of qualification and membership number, if applicable) / Solicitor
Barrister
Chartered Legal Executive
Month and year of qualification:
Professional body membership number[2]:
Current contact details: / Telephone Number (Mobile or landline):
Email address:
Information provided in the following sections will be shared with a potential mentor as part of the process of securing a mentor
Career history
Please give details below of your career history for the last 5 years, including the areas of law in which you have built expertise through professional experience or in the judicial posts you have held. Please limit your description of experience to 300 words.
Date From / Date To / Chamber, firm, organisation, judicial appointment / Area of lawPart C: Your requirements
The aim will be to match a mentor holding, or who has held, the judicial role of interest and who is based within reasonable travelling distance of the mentee. If this is not possible, other areas of compatibility or alternative methods of communication will be considered.
Please state:
Judicial role of interest (E.g. Tribunal judge – Employment Tribunal):Preferred location(s):
Please provide below any other information which you consider relevant in assisting us in securing a mentor
Please cross to confirm that you have read and agreed the Terms and Conditions of the Judicial Mentoring SchemePlease email the completed from to:
If you have any queries about the form, please call 020 7073 1610
Terms and Conditions
To participate in this scheme all mentees must agree to the following terms and conditions.
- The Scheme will be administered by the Judicial Office and the allocation of mentors to mentees will be at its sole discretion. In the event that the Judicial Office is unable to identify a suitable mentor for a particular mentee, that mentee's name will be placed on a waiting list until a suitable match can be been identified.
- All mentors are volunteers; they make no guarantees or promises regarding any advice imparted to mentees. Membership of the mentoring scheme confers no preferential status in any competition and cannot guarantee success.
- Mentor and mentee enter a partnership that is voluntary and based on mutual trust. Either party is permitted to terminate the relationship at any time.
- Mentees will only be permitted to have one mentor at any one time.
- All conversations should be considered confidential by both parties, and not disclosed by any party without agreement from the other. However, should circumstances have arisen which have led to the mentor terminating the relationship[3], the mentor may feel obliged to take additional steps which may include notifying the Judicial Office.
- Mentees agree to respect the boundaries of the mentoring relationship, and will not attempt to contact their mentor outside of the terms agreed at the outset of the relationship.
- The Judicial Office reserves the right, at any time and at its sole discretion, to amend these terms and conditions.
[1] The Diversity Committee has decided to use educational backgrounds as a basis for measuring social mobility in the judiciary.
[3]For example, if the mentee reveals that he/she is:
abusing drugs or alcohol
bankrupt or at imminent risk of bankruptcy
or has been guilty of serious professional misconduct
engaging in any activity that is likely to impede the carrying out of his/her duties and/or to cause embarrassment to the legal profession or the judiciary (for example by attracting the attention of the press)