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AEA-Retired Intergenerational Mentor Application
About You
1.
First,Last Names
2.
Email:
3.
Phone:
4.
Street Address
5.
City/State/Zip Code
6.
Degrees Achieved
7.
Teaching Experience
8.
Certified Subject(s):
9.
Total Years Taught
10.
Grade Levels and/or subjects taught
Your answers to the next questions will help us match you with your student.
11.
What interests you about being a mentor?
12.
List interests and activities that shaped you as an educator.
13.
What strengths do you bring to the mentoring program?
14.
Note any questions, comments or concerns you have about the program.
15.
On Saturday, October 27 11AM-4PM, a mandatory mentor training will be held at AEA Headquarters, 345 East Palm Lane, Phoenix, AZ 85004. (Please check and mark your calendar now.) Will you be able to attend?
Yes
No
Other (please specify)
16.
On Monday, October 29 10AM-3PM, a mandatory mentor training will be held at AEA Headquarters, 345 East Palm Lane, Phoenix, AZ 85004. (Please check and mark your calendar now.) Will you be able to attend?
Yes
No
Other (please specify)
