CTE Teacher Certification Program Verification of Mentor Visits Directions: Form to be completed by the Mentor and signed by the Mentor and CTE Director. Upon completion of the mentor activities, submit the original to the CTE Director and mail or e-mail a scanned copy to Niketa Dean at . By mail to, Office of Career and Technical Education/Workforce Development, Alabama Department of Education, P.O. Box 302101, Montgomery AL 36130-2101. Semester 1 Program Mentor Session I (October -December) Date of Visit Type Visit Comments New Teacher Visits Mentor at Mentor’s school One (Visit Required) Mentor Visits New Teacher at Mentee’s school Two (Visit Required) Mentor/Mentee - check one below: Via Telephone and Emails (6 hours total) Three Visit occurred off-site at a mutual location and is relative to the program being taught Mentor/Mentee Visit - check one below: Via Telephone and Emails (6 hours total) Four Visit occurred off-site at a mutual location and is relative to the program being taught Semester 2 Program Mentor Session II (January-May) Visit Type Visit Date of Visit Comments New Teacher Visits Mentor at Mentor’s school One (Visit Required) Mentor Visits New Teacher at Mentee’s school Two (Visit Required) Mentor/Mentee Visit - check one below: Via Telephone and Emails (6 hours total) Three Visit occurred off-site at a mutual location and is relative to the program being taught Mentor/Mentee Visit - check one below: Via Telephone and Emails (6 hours total) Four occurred off-site at a mutual location and is relative to the program being taught Program: Mentor’s Name: Mentee’s Name: Mentor’s School System: Mentee’s School System: Mentor’s CTE Director: Mentee’s CTE Director: Date Signature of Mentor’s CTE Director Date Signature of Mentor
CTE Teacher Certification Program Verification of Mentor Visits Directions: Form to be completed by the Mentor and signed by the Mentor and CTE Director. Upon completion of the mentor activities, submit the original to the CTE Director and mail or e-mail a scanned copy to Niketa Dean at . By mail to, Office of Career and Technical Education/Workforce Development, Alabama Department of Education, P.O. Box 302101, Montgomery AL 36130-2101. Semester 1 Program Mentor Session I (October -December) Visit Type Visit Date of Comments One New Teacher Visits Mentor at Mentor’s school (Visit Required) Two Mentor Visits New Teacher at Mentee’s school (Visit Required) Three Mentor/Mentee - check one below: Via Telephone and Emails (6 hours total) Visit occurred off-site at a mutual location and is relative to the program being taught Four Mentor/Mentee Visit - check one below: Via Telephone and Emails (6 hours total) Visit occurred off-site at a mutual location and is relative to the program being taught Semester 2 Program Mentor Session II (January-May) Visit Type Visit Date of Visit Comments One New Teacher Visits Mentor at Mentor’s school (Visit Required) Two Mentor Visits New Teacher at Mentee’s school (Visit Required) Three Mentor/Mentee Visit - check one below: Via Telephone and Emails (6 hours total) Visit occurred off-site at a mutual location and is relative to the program being taught Four Mentor/Mentee Visit - check one below: Via Telephone and Emails (6 hours total) occurred off-site at a mutual location and is relative to the program being taught Program: Mentor’s Name: Mentee’s Name: Mentor’s School System: Mentee’s School System: Mentor’s CTE Director: Mentee’s CTE Director: Date Signature of Mentor Date Signature of Mentor’s CTE Director
Mentor%20Verification%20Form.docx