If you are human, leave this field blank.
Best way/times to contact you
Have you ever been convicted of a crime?
If "Yes", please explain
Describe your teaching experience
I teach (or have taught) in: Please check any that apply and write how many years.
Please specify how many years in each:
Which areas of piano teaching do you want to observe? Please check any that apply.
Specific Period (e.g. Contemporary period)
Can you speak any other languages?
What days or evenings are you available and during which hours?
How often would you be available for observation? (For example: every week, once a month)
For how long a period would you be available for observation? (For example: four weeks, three months)
How do you participate in NEPTA? (Do you attend monthly meetings, teachers’ exchanges, present students in recitals or competitions, serve on a committee or on the NEPTA Board?
What requests do you have of a Mentee in your studio?
I will bill my Mentee
only for discussion of any pedagogical issues outside of the teaching observation time, either in person, by phone or per email in accordance with the Billing Agreement signed by both parties.
DISCLAIMER AND WAIVER OF LIABILITY
I understand and agree that neither New England Piano Teachers Association (“NEPTA”) nor any Mentee associated with the Mentorship Program of the NEPTA shall be responsible for any bodily injury, property damage, or loss sustained or incurred by me during the time I am participating in the Mentorship Program. I hereby waive, forfeit, and forever release NEPTA and its Mentees, their successors and/or assigns from any liability, whether personal or professional.
I agree to share the information on this application with prospective Mentees and the Mentoring Committee.
I certify that the above information is accurate, to the best of my knowledge.
Please type your full name in the box below. By typing your name and submitting this form to the NEPTA Mentoring Program Committee, you are agreeing to the terms as stated above.
Please provide two references who are willing to be contacted by a NEPTA Mentoring Program Committee member.
Apply to be a NEPTA Mentor