Visitors Feedback
Please be honest when completing this form.
Your Name
*
First Name
Last Name
Group Name
*
Use the name that appears on your Roots Rating
Region
*
i4118
African Angels
Bloemfontein
CPT Belhar
East London
Greytown
Hluvukani
Inanda
JHB Alberton
JHB Central
JHB North
JHB South
JHB West
Kidds Beach
Midrand
On-line
Polokwane
Pretoria
QWAQWA
VAAL - Vereeniging
West Rand
Date of Group Visit
*
-
Day
-
Month
Year
Date
Candidate MENtor name
*
First Name
Last Name
Was He on Time
*
Yes
No
If No, Why?
*
Was he respectful
*
@ Not at all
@@ Below Ave.
@@@ Above Ave.
@@@@ Completely
Did he engage with the boys
*
@ Not at all
@@ Below Ave.
@@@ Above Ave.
@@@@ Completely
Did he participate in the activity
*
@ Not at all
@@ Below Ave.
@@@ Above Ave.
@@@@ Completely
Was he easy to be around
*
@ Not at all
@@ Below Ave.
@@@ Above Ave.
@@@@ Completely
Would you recommend him as a potential MENtor
*
Yes
No
Unsure
If No or Unsure, please explain why?
*
General Comments/Feelings
Submit
Should be Empty: