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MENTOR FEEDBACK Powered By Docstoc
					                                     MENTOR FEEDBACK

Date: ______________________

Mentee’s name: ______________________________________

Mentor’s name: ______________________________________

Date of first contact: ___________________

How’s your relationship going? Circle one.

Great           Good             Fair             Poor            Nonexistent

How often have you been meeting?

How often do you talk by phone?

What have you and your mentee been doing together?

Is there anything special you and your mentee are working on?

Is there something the program can do to support you? (such as training or information, help
from the program coordinator in facilitating contacts, etc.)

Any other thoughts or comments?

Courtesy of The Maryland Mentoring Partnership, Vision to Reality Mentoring Program Development Guide.

Lingjuan Ma Lingjuan Ma MS
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