Application for Mentorship

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Thank you so much for applying to be a mentee in our program. Please note, that this program is voluntary. We will do our best to match you with a mentor that fits your needs.

What is your last name? *

What is your first name? *

Email: *

Years of formal, district-contracted, full-time teaching experience: *

Less than a year

1-3 years

3-5 years

5-8 years

8-15 years

15 + years

Which of the following levels are you currently teaching? (Please choose all that are applicable) *

Elementary (K-5)

Middle School (6-8)

High School

Required

Classes and ensembles currently taught: (please choose all that are applicable) *

Marching Band

Concert Band

Jazz Band

Musical Pit

Small Instrumental Ensembles

Beginning Band

General Music

Music Appreciation

Other:

Required

My current teaching environment is best described as: *

Urban

Suburban

Rural

In which region of the country are you located? *

Eastern Division [CT, DE, ME, MD, MA, NH, NJ, NY, PA, RI, VT]

North Central Division [IL, IN, IA, MI, MN, NE, ND, OH, SD, WI]

Northwestern Division [AK, ID, MT, OR, WA, WY]

Southern Division [AL, FL, GA. KY, LA, MS. NC, SC, TN, VA, WV]

Southwestern Division [AR, CO, KS, MO, NM, OK, TX]

Western Division [AZ, CA, HI, NV, UT]

What is the name of your school (including HS, MS, Elem, University)? *

What is the name of your school district? *

What type of degree(s) and/or certifications do you hold? *

Which categories describe your top three needs or interests? *

Rehearsal Strategies

Lesson Planning and Score Study

Specific Instrument Pedagogy

Classroom Management

Curriculum Development

Creating Assessments

Incorporating Technology

Recruitment Techniques

Techniques for Building Relationships

Band Booster or Parent Organizations

Instrument Repair

Concert/Performance Preparation and Traveling for Performance

Fundraising and Building Financial Support (Donations)

Budgeting

Grant Writing

Administrative Needs

Scheduling

Additional Professional Development

Mentor Evaluations with people in your school

Graduate Programs

Student Learning Objectives (SLO)

Incorporating Common Core

As a mentee, what would be the most effective way for you to receive feedback? (please check all that apply) *

Phone

Video/Audio Review

On-Site Observations

In Person Meetings

Required

Do you have experience with video conferencing services such as: FaceTime, Skype, or Google Hangouts? *

Yes

Scheduling: Please choose all that apply. *

I teach homogeneous sectionals.

I teach mixed instrument sectionals.

My classes are split by grade-level.

My classes are split by ability-level.

I am a traveling teacher.

Required

Where did you hear about the Dr. William P. Foster Mentorship Initiative? *

Referred by a friend or colleague

Referred by an administrator

Social media

National Band Association (NBA)

NAfME (National Association for Music Education)

CBDNA (College Band Directors National Association)

Music for All

Other:

Additional Comments:

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