Coach Mentorship Program Signup Form Name(Required) First Last PronounsEmail(Required) PhoneGeographic Location City State / Province / Region Number of Years Coaching ExperienceHow many mentees are you willing to take on this year? 1 2 (max) AvailabilitySelect all that applyMonthly Time Commitment(Required) Available for one check-in per month (mandatory for program) Preferred Days Weekdays Weekends No Preference Preferred Time of Day Morning Afternoon Evening Flexible Background and Shared ExperiencesThis information helps us make thoughtful mentor–mentee matches. Please select anything that feels relevant. There are no “right” answers, and you do not need to select everything that applies.Teaching and School ContextSelect all that apply. Middle School Program High School Program Independent School Faith-Based School Title I School Rural School Urban School Small Program Large Program Professional Role and BackgroundSelect all that apply. I teach speech and debate in the classroom. I teach another subject in the classroom. I coach speech and debate as an extracurricular activity. I am retired from coaching. If you teach another subject, which subject(s)?Select all that apply. Math English/Language Arts Science History/Social Studies Fine Arts AP Seminar Other Subject Are Life Experiences and PerspectivesSelect anything that reflects life experiences that may shape your coaching context. Coaching while raising young children Coaching while supporting school-age or teenage children Coaching while supporting extended family Coaching while balancing multiple professional roles Coaching after returning from a break or career transition Coaching while new to a school, district, or community Other Life Experiences OtherIs there anything about your background, experience, or perspective that you think could help us make a thoughtful mentor–mentee match?Optional. One or two sentences is plenty.
