Monthly Leadership Coaching Reflection
Please complete this form after every Leadership Coaching session. The form should be completed by both the mentee and the coach.
Name
*
First Name
Last Name
Email
*
example@example.com
Date of Coaching Session
*
-
Month
-
Day
Year
Date
Type of Meeting
*
Please Select
Video Conference
In-Person
Telephone
Which best describes you?
*
Leadership Coach Volunteer
Cocoon Club Member
Which Leadership Coaching agenda was used during this session?
*
Please Select
No Agenda
Month 1 Agenda
Month 2 Agenda
Month 3 Agenda
Month 4 Agenda
Month 5 Agenda
Agree or Disagree: This month's coaching agenda was helpful in guiding my Leadership Coaching session.
*
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
N/A - No Agenda
Month 1: Which portions of the Month 1 agenda did you talk about during this coaching session? Check all that apply.
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Leadership Identity
LOVE Coaching Framework
Our "Why" (i.e., why we joined Butterfly Dreamz)
Leadership Coaching Goals
Other
Month 2: Which portions of the Month 2 agenda did you talk about during this coaching session? Check all that apply.
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Coaching Agreements (e.g. The 4 Agreements)
Opportunities & Threats (Candace's scenario)
Head, Heart, & Gut Decision-Making
SMART goals & GROW model
Other
Month 3: Which portions of the Month 3 agenda did you talk about during this coaching session? Check all that apply.
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Coaching Agreements (e.g. The 4 Agreements)
Validating Girl Leaders (Validating Coco video)
The Leadership Journal
SMART goals & GROW model
Other
Month 4: Which portions of the Month 4 agenda did you talk about during this coaching session? Check all that apply.
*
Coaching Agreements (e.g. The 4 Agreements)
Leadership Portfolio Brainstorming
SMART goals & GROW model
Other
Month 5: Which portions of the Month 5 agenda did you talk about during this coaching session? Check all that apply.
*
Coaching Agreements (e.g. The 4 Agreements)
Leadership Portfolio Gallery/Reflections
Butterfly Dreamz Scholarships Review
Growth & Gratitude Conversation
SMART goals & GROW model
Other
Did you talk about any other topics during this coaching session? Check all that apply.
*
School/Academics
Life After High School
Family/Home Life
Friends/Relationships
Work/Employment
Self/Leadership Development
Mental Health & Well-being
Other
Did you talk about everything you hoped to talk about during the session?
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Yes
No
Not Sure
What do you think went well during this month's session?
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What do you think are areas for improvement?
*
On a scale of 1 star (awful) to 5 stars (phenomenal), how well do you think your relationship is going with your mentee?
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1
2
3
4
5
On a scale of 1 star (awful) to 5 stars (phenomenal), how well do you think your relationship is going with your Leadership Coach?
*
1
2
3
4
5
On a scale of 1 star (awful) to 5 stars (phenomenal), how well do you think your relationship is going with your Butterfly Dreamz Big Sister?
*
1
2
3
4
5
Who have you received coaching or mentorship from this month outside of today's session?
*
My Leadership Coach (not including today's session)
Another Cocoon Club Member
Butterfly Dreamz Staff Member
Someone from my personal network
No one
Other
Who have you received coaching or mentorship from this month outside of today's session?
*
My Butterfly Dreamz Big Sister (not including today's session)
Another Cleveland 7th or 8th grade girl
Another Cocoon Club Member
Butterfly Dreamz Staff Member
Someone from my personal network
No one
Other
Please tell us whether you AGREE or DISAGREE with the following statements.
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Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
In the last 30 days, I've made progress toward my goal(s).
In the last 30 days, I've developed new skills.
In the last 30 days, I've became more curious about other opportunities for growth.
Talking with my Leadership Coach today was beneficial.
Today's coaching session was good for my mental health and wellbeing.
Please tell us whether you AGREE or DISAGREE with the following statements.
*
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
In the last 30 days, I've made progress toward my goal(s).
In the last 30 days, I've developed new skills.
In the last 30 days, I've became more curious about other opportunities for growth.
Talking with my Butterfly Dreamz Big Sister today was beneficial.
Today's coaching session was good for my mental health and well-being.
OPTIONAL: Do you need additional assistance from Butterfly Dreamz staff? If so, please describe what you needed additional assistance with:
Submit
Should be Empty: