Application to serve as Mentor
Thank you so much for nominating yourself as a mentor. Please note, that participation in this program is based on the needs of our mentee regions. If we do not need you at this present time, we will keep your information in our database. Please expect a response from us in 10 business days. Thank you for taking this initiative and we look forward to growing the mentorship program.
What is your last name?
What is your first name?
Years of formal, district-contracted, full-time teaching experience:
Less than a year
15 + years
Which of the following levels are you currently working with? (Please choose all that are applicable)
Middle School (6-8)
Retired Band Director
Areas of current experience: (please choose all that are applicable)
Small Instrumental Ensembles
My current teaching environment is best described as:
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]
Do you have previous experience as a mentor? (Please note that previous experience is not required!)
What is the name of your school (including HS, MS, Elem, University)?
What is the name of your school district? (Please include district #)
What type of degree(s) and/or certifications do you hold?
Which categories describe your top three strengths?
Lesson Planning and Score Study
Specific Instrument Pedagogy
Concert/Performance Preparation and Traveling for Performance
Band Booster or Parent Organizations
Techniques for Building Relationships
Fundraising and Building Financial Support (Donations)
Strategies to be a Successful Traveling Teacher
Additional Professional Development
Student Learning Outcomes (SLO)
Incorporating Common Core
As a mentor, what would be the most effective way for you to give feedback? (please check all that apply)
In Person Meetings
Do you have experience with video conferencing services such as: FaceTime, Skype, or Google Hangouts?
Scheduling: Please choose all that apply.
I have experience teaching homogeneous sectionals.
I have experience with mixed instrument sectionals.
I have experience with classes that are split by grade-level.
I have experience with classes that are split by ability-level.
I have experience as a traveling teacher.
Where did you hear about the Title 1 Mentorship Program?
Referred by a friend or colleague
Referred by an administrator
National Band Association (NBA)
Nafme (National Association for Music Education)
CBDNA (College Band Directors National Association)
Music for All
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