Additional ACTIVITY
This form will be used to submit all ADDITIONAL ACTIVITIES completed with each teacher you mentor.
The submitted form becomes the official documentation for mentor pay.
The email address you enter below will receive a copy of the submitted form.
Enter your email to send to yourself and then forward to the teacher OR send it directly to the teacher by entering their email below.
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Email *
School *
Teacher Specialist *
Mentor FIRST Name *
Mentor LAST Name *
Provisional Teacher FIRST Name *
Provisional Teacher LAST Name *
Additional ACTIVITY Completed: *
This activity was completed on this date: *
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DD
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YYYY
Have you given the provisional teacher a copy of the documentation used (i.e. Reflective Conversation, Observation Sheet) to keep in their file? *
In what ways did this activity improve the teacher's instructional practice? Use examples. *
Including this ACTIVITY, how many Additional Activities has this provisional teacher completed so far on their Documentation of Mentoring form?  Please initial completed activities on their Documentation of Mentoring form. *
The email address I entered at the top will get a copy of the submitted form for an Additional ACTIVITY. *
A copy of your responses will be emailed to the address you provided.
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