Mentor Reference Form


Please have 3 individuals complete the following form online.

 Make sure that they have a strong grasp of your teaching abilities. One reference must come from each of the following: your current principal, a parent/guardian of a current student, and a colleague (This can be another teacher, teacher's aide, or another administrator within your school/district). All references will be contacted at some point through the application process to verify their endorsement.

If you have any questions please contact David Montague at 901-818-5148 or via email at david@MemphisTR.org

Thank you for your time!


Applicant's First Name
Applicant's Middle Name (if known)
Applicant's Last Name
Please assess the applicant appropriately for: MORAL CHARACTER/ INTEGRITY
Please assess the applicant appropriately for: PROFESSIONALISM
Please assess the applicant appropriately for: SUBJECT MATTER KNOWLEDGE
Please assess the applicant appropriately for: SERIOUSNESS OF PURPOSE
Please assess the applicant appropriately for: RESILIENCY
How long have you known the applicant and in what capacity?
How would you rate the applicant's Instructional Practices?
How would you rate the applicant's Classroom Management?
How would you rate the applicant's Relationship Skills?
Has the applicant had any disciplinary, criminal, or social problems?
How effective is the applicant as a teacher in an urban school?
Any further comments you might wish to state regarding the applicant?
Please indicate your recommendation regarding this applicant
Your Legal Name
Telephone Number
Relationship to Applicant
Email Address
Address (include city/state)