CBA Professional Success Application Form
Please fill out this form to express interest in the CBA Professional Success Program!!!

Logistics of connecting directors with mentors:

-Check our website for the list of available mentors and information on each of them - their experience, expertise, etc.

-Director contacts the mentor of their choice to schedule a date and time that will work for both of them. Director may want to speak with a few mentors to see who they fit best with. New to the state? Looking for the right connection? CBA can be contacted for guidance.

-Pre-payment must take place before CBA confirms the actual clinic.

-CBA will check that the clinic has been set, with the clinic price structure, including mileage reimbursement  (40 cents/mile, minimum 100 miles roundtrip), if applicable.

-Dr. Cannava will set up a custom payment link in the website for each request, under Professional Success Program.

-When payment is made, we will let the director and mentor know they are good to go.

-Once the director and mentor confirm the clinic has been completed, Dr. Cannava will mail the mentor a check for their services.
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Director Name *
School District *
School(s) *
What level of support are you requesting? *
I am interested in the CBA Matching Funds Grant (you will be contacted by CBA to inform you of the availability of funds) *
My mentor request is (please reference the CBA website for bios on these amazing mentors!!!!)  I have communicated with them. *
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