Monthly Mentor Survey
Please complete at the end of each month.
Mentor's Name:
*
Mentee's Name:
*
Mentee's Age
*
Month:
*
Please Select
January
February
March
April
May
June
July
August
September
October
November
December
Which life skills were discussed / demonstrated this month? Select all that apply
Self Care
Household Skills
Career
Driver's License / Car Maintenance
Education
Relationships
Budget / Financial
Extracurricular / Community Involvement
Any comments or concerns:
Did you work on any goals this month?
Yes
No
If yes, please describe.
Is there any additional support you need from Mentor Manager or Case Managment for your youth?
Submit
Should be Empty: