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KGTC Mentee Application
Thank you for your interest in becoming a new Gifted Facilitator mentee!
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First Name
Your answer
Last Name
Your answer
Address
Your answer
Phone Number
Your answer
Email address
Your answer
School District
Your answer
In which KGTC Region do you reside?
Region 1
Region 2
Region 3
Region 4
Region 5
Region 6
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How many years of teaching experience do you have?
Your answer
How many years of experience working with Gifted Learners do you have?
Your answer
What are some areas in which you would like support?
Identification
Social/Emotional
Differentiation
Elementary
Secondary
Diverse student populations
Twice Exceptional
Serving students in rural communities
Serving students in urban communities
Writing IEP's
Underachieving gifted learners
Executive Function
Perfectionism
Planning lessons for pull-out
Other:
Personal statement: Explain your interest in this program, describing your passion for and experience working with gifted and talented individuals. (300 words or less)
Your answer
Describe what gifted services look like in your district. (50 words or less)
Your answer
How do you hope this program will impact change in your school(s)/district? (100 words or less)
Your answer
Preferred method of contact:
Email
Phone call
Text
Best times to contact (during the school year):
Before school
During the Daytime
After school
Evenings
Weekends
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