Mentor Monthly Check In

1

Name

First Name

Last Name

2

Which month is this check in for?

3

Have you met with your mentee in person this month yet?

YES

NO

4

What was the date of your meet up?

Date

5

How many hours did your meet up last?

6

What did you do during your meet up?

7

Have you met with your mentee more than once so far?Don't include a meeting you've previously reported.

YES

NO

8

Please let us know the date, location, time length, and activity of any additional in person meetings.

9

How often have you spoken with your mentee this month?This includes phone, text, FaceTime, zoom, etc.

12

Have you noticed any areas of improvement or change with your mentee?

13

Are there additional ways we can support you or your mentee?