Mentorship Pairing Questionnaire
This is the questionnaire to better the pairing process for mentors and mentees.
Name
First Name
Last Name
Age
18-29
30-49
>50
Education (check the highest degree achieved)
Diploma
Associates
BSN
Do you have plans to continue your education?
Yes
No
Are you intending to be a mentor or mentee?
Mentor
Mentee
How would you describe your personality?
Please Select
I keep to myself.
I talk to people sometimes.
I tend to talk to people often.
I am very outgoing.
What are your hobbies outside of work?
Cooking
Gardening
Outdoor Sports (hiking, kayaking, biking, skiing, hunting, fishing, camping, etc.)
Crafts (sewing, knitting, painting, scrapbooking, etc.)
Planes, Trains and Automobiles
Technology Activities (computer gaming, video games, photography, etc.)
How would you describe your organizational preference?
Type A
Type B
Are you a better texter or emailer?
Texter
Emailer
How often do you want to be in contact with your mentor/mentee?
Twice a Week
Once a Week
Every other Week
When you think about communicating with your mentor/mentee, how do you envision the relationship?
More casual – we will contact each other when we want to talk, knowing that the other person will be available for me when needed.
More structured – we will schedule phone calls, e-mails, or personal meetings to ensure we keep up with one another.
Submit
Should be Empty: