OKLAHOMA DEPARTMENT OF CAREER AND TECHNOLOGY EDUCATION
MENTOR REIMBURSEMENT FORM
This
form will serve as documentation that
fulfilled the
requirements of documenting at least 72 hours spent as mentor to
during the
(FY ) and is eligible to receive a stipend in the amount of $500.00
through the Oklahoma Department of Career and Technology Education for these
services. Details of the documented time are maintained in the mentor's
personal file at
.
This time was under the supervision of
.
(Name of instructional leader)
This form is verified this
day of , .
Signature of Mentor Signature of Mentee
Signature of Instructional Leader Signature of ODCTE Representative
Legal requirements
mandate original signatures on this document
Please fill out the
form, print it, secure the required signatures and mail it by April 20th to:
Lynn Hughes, Process and Planning Specialist
Instructional Services
Division
Oklahoma Department of Career & Technology Education
1500 West Seventh Avenue
Stillwater, OK 74074-4364.
This Web site is maintained by Travis Miller tmill@okcareertech.org
Last update 07/13/2006
Web pages copyright 2000 Oklahoma Department of Career and Technology
Education
