2019-2020 Orion Mentor Program Registration
Thank you for choosing Orion to host your mentoring program this year! Please complete the fields below as accurately as possible. A separate form submission is needed for each new teacher, counselor, specialist, and administrator you are enrolling.

Member Pricing:
$375 for each 1st-year teacher, counselor, reading specialist, library media specialist, and administrator
$375 for each mentor of the educators listed above
$150 for each 2nd-year teacher
$150 for each mentor of 2nd-year teachers
$750 for admin mentoring if an Orion consultant serves as the mentor

Non-Member Pricing:
$490 for each 1st-year teacher, counselor, reading specialist, library media specialist, and administrator
$490 for each mentor of the educators listed above
$200 for each 2nd-year teacher
$200 for each mentor of 2nd-year teachers

Closer to the training dates, Orion will email the educators personally to find out which training dates they plan to attend. If you have any questions, please contact Shannon Fisher, 316-992-7984 or sfisher@orioneducation.org

What is your USD number? (ex 262) *
Your answer
What is the name (first and last) of the new teacher, counselor, specialist, or administrator? *
Your answer
What is the email address of the new teacher, counselor, specialist, or administrator? *
Your answer
Which level of mentoring is needed for the 19-20 school year? *
What grade levels/content areas will this educator serve? *
Your answer
What is the name (first and last) of the Mentor? (if an Orion consultant will serve as the mentor, type "Orion") *
Your answer
What is the email address of the Mentor? (if an Orion consultant will serve as the mentor, type "Orion") *
Your answer
What grade levels/content areas will the Mentor serve? (if an Orion consultant will serve as the mentor, type "Orion") *
Your answer
Does the Mentor have a professional license in effect? (Mentors of school specialists, counselors, and admins must have a professional license in the specific specialty area being mentored.) *
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