Mentoring Program Check-In Log
Mentor Name
First Name
Last Name
Mentee Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Meeting Start
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Type of meeting
In person on camus
In person off campus
Email
Phone
Other
Focus of meeting
Getting to know each other
Involvement with clubs/student groups
Food, shelter, transportation insecurities
Academic and curricular resources
Time management
Cultural experiences
Work, school, and life balance
Money management, financial aid, scholarships
General check-in
Certificate and degree goals
Classes for next semester
Transfer goals
Career and professional goals
Barriers experienced on campus
Other topics covered in meeting:
Connected mentee with the following resources:
Goals, next steps, and/or action plan:
Overall satisfaction with meeting
*
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
Overall satisfaction
1
2
3
4
5
Other Comments
Submit
Should be Empty: