Mentor M.E. 2022 Mentee Interest

All Mentor M.E. interest forms are due by 11:59 PM CT on Monday, November 1, 2021.

Name*

First Name

Last Name

Email*

Mailing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

City/State Where You Teach*

School Name *

School District*

Current Job Title: *

How many years have you been teaching?*

What is your expertise or area of focus in music?*

What are you hoping to gain from this experience?*

Are you able to commit to meeting with your mentor 3-4 times over the next several months?*

Is your supervisor aware that you are participating in this mentorship program?*

Please include your Principal’s email *

Please include your Fine Arts Director’s email (if applicable)*

Please include your Superintendent's email*