Mentor Application Form

Download blank copies of Form C – Collaborative Log and Form C1 – Mentor Log.

Fill these out and upload them below before submitting this form.

Form A: New Principal Mentoring Program Mentor Application

  • List all full-time Illinois principalships including name of school, district, grade span, and full years of experience at each school.
  • B: Please respond to the following two (2) prompts.

  • C. Professional References:

    List the names and full contact information of at least three professional references. You must include a written reference from a superintendent or assistant superintendent who served as your direct supervisor, a certified teacher leader who served at least one full year under your supervision, and a principal colleague who observed or knows your work.

  • D. Letters of Reference

    Attach three (3) letters of reference from the professionals listed above which address the following requirements to be a DNPMP coach:

    • Evidence of strong ethical character
    • Evidence of strong inter-personal skills
    • Evidence of instructional leadership (defined as but not limited to:) ability to facilitate a vision of learning within a school, ability to develop and sustain a collaborative professional learning community, ability to develop and sustain a positive school culture and instructional program, ability to effectively advocate for students by influencing the greater political, social, economic, legal, or cultural context of the professional learning community
    • Nature of the working relationship between you and the reference
    • One or more specific examples of your accomplishments related to the IPSL standards noted above.
  • Upload each letter individually.
  • Upload each letter individually.
  • Upload each letter individually.
  • By filling in this field with your full name, you are providing a digital signature.
  • This field is for validation purposes and should be left unchanged.