22-23 Mentor Program Registration

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Thank you for choosing Orion to host your mentoring program this year! Please complete the fields below as accurately as possible. Separate submission forms are 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

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 Tanya Jacobucci at tjacobucci@orioneducation.org or 316-305-0605.

What is your USD number? (ex 262) *

What is the name (first and last) of the new teacher, counselor, specialist, or administrator? *

What is the email address of the new teacher, counselor, specialist, or administrator? *

Which level of mentoring is needed for the 20-21 school year? *

First-Year Transition to Teaching

Second-Year Transition to Teaching

First-Year Classroom Teacher

Second-Year Classroom Teacher

First-Year Counselor

First-Year Reading Specialist

First-Year Library Media Specialist

First-Year Administrator

What grade levels/content areas will this educator serve? *

What is the name (first and last) of the Mentor? (if an Orion consultant will serve as the mentor, type "Orion") *

What is the email address of the Mentor? (if an Orion consultant will serve as the mentor, type "Orion") *

What grade levels/content areas will the Mentor serve? (if an Orion consultant will serve as the mentor, type "Orion") *

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.) *

Yes

Not Sure

Submit

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