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CSM Mentor Log 2023-2024
Mentor Log Sheet
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* Indicates required question
Email
*
Your email
Mentor name
*
Last name, First name
Your answer
Mentee name
*
Last name, First name
Your answer
Please use the tell us about this month's meeting with your mentee.
Date of Meeting
*
DD/MM/YY
Your answer
Type of Meeting
*
In Person
Video Call (Zoom, Skype, etc.)
E-mail Meeting
Telephone Meeting
Did Not Meet
Online
Other:
Duration of Meeting
*
Less than 30 minutes
30 - 60 minutes
Over 1 hour
Did Not Meet
Were you able to meet with your mentee for the minimum amount of time required by the program?
*
Yes
No
Required
If you answered no to the previous question, please discuss below.
Your answer
On a scale from 1 - 5, how would you rate the quality of your current relationship with your mentee.
*
Choose
Extremely Poor
Below Average
Average
Above Average
Excellent
Please give us a brief update on how your relationship is progressing with your mentee.
*
Your answer
On a scale from 1 - 5, how would you rate how well your mentee is doing.
*
Choose
Extremely Poor
Below Average
Average
Above Average
Excellent
Please give us a brief update on how your mentee is doing.
*
Your answer
Is there anything you would like to share with The Center for Inclusive Education or is there anything you feel requires intervention or notification of the CIE-CSM staff?
*
Yes
No
Required
If you answered yes to the previous question, please discuss below.
Your answer
A copy of your responses will be emailed to the address you provided.
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