Thomas - Mentor Request

Thomas University
Teacher Leadership Program Mentor Request Form

Applicant Information

Applicant's Full Name *

I understand that as a candidate in the Education Specialist or Master of Education Teacher Leader Program at Thomas University, I will be required to participate in field experiences to complete certification requirements. To be successful in these field experiences, I will be required to obtain a school-based Mentor to assist and support me.

Keep in mind that a good mentor has several qualities:

• Enough time to support my teacher leader activities and learning,
• The authority to provide me with time to observe and coach colleagues,
• Willingness to encourage me as a student and teacher leader,
• Knowledge of the School Improvement Plan and current school initiatives to help the teacher leader plan out GACE tasks,
• The time to communicate with my TU professors during Residency courses.

Applicant Signature *

Applicant Date * +

Mentor Information

Once you choose a Mentor, and that person agrees to support you, please request that the individual below complete the School System Administrator-Designated Mentor Agreement form on your behalf.

Administrator's Name *

Administrator's Email Address *