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A copy of the form should be placed in the applicant s personnel folder. I have served as a mentor for the applicant named above during the current school term. Mentor s Signature Date I have provided an induction/mentorship program for the applicant named above. Form OEL 02-04 Sec. F MENTORSHIP / INDUCTION / EVALUATION FORM Required only for applicants in the Mississippi Alternate Path to Quality Teachers Program. To be completed by the applicant Name Last First Middle/Maiden Social Security Grade/Subject School District School Term Superintendent Principal Mentor Applicant s Signature Note The original of this form should be included in the licensure application packet. The evaluation of the applicant s performance is satisfactory unsatisfactory check one. Principal s Signature Note The principal shall conduct one or more evaluations of the applicant s performance using the same evaluation tools applied to the evaluation of all teachers. The principal shall then indicate if the applicant s performance is satisfactory or unsatisfactory. PLEASE NOTE This original form is to be returned to applicant for inclusion in application packet. A copy of the form is to be included in applicant s personnel folder. The evaluation of the applicant s performance is satisfactory unsatisfactory check one. Principal s Signature Note The principal shall conduct one or more evaluations of the applicant s performance using the same evaluation tools applied to the evaluation of all teachers. The principal shall then indicate if the applicant s performance is satisfactory or unsatisfactory. The principal shall then indicate if the applicant s performance is satisfactory or unsatisfactory. PLEASE NOTE This original form is to be returned to applicant for inclusion in application packet. A copy of the form is to be included in applicant s personnel folder. The evaluation of the applicant s performance is satisfactory unsatisfactory check one. Principal s Signature Note The principal shall conduct one or more evaluations of the applicant s performance using the same evaluation tools applied to the evaluation of all teachers. The principal shall then indicate if the applicant s performance is satisfactory or unsatisfactory. PLEASE NOTE This original form is to be returned to applicant for inclusion in application packet. A copy of the form is to be included in applicant s personnel folder.

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