Buffalo Prep Mentor Me Program - Volunteer Monthly Report
Please fill out this report and submit by the 5th of each month. All information is confidential. Please contact buffaloprepmentoring@gmail.com with any questions. Thank you!
Email address *
Today's date *
Month of Report: Please indicate the month you are reporting for. *
Report Year *
First Name *
Last Name *
Mentee's name *
Hours spent visiting your mentee in person: *
Number of visits *
Hours spent keeping in touch electronically (text message, email, phone, etc.) *
Please describe the activities of your visits (i.e. met for coffee, went for walk/exercise, discussed future goals and colleges, etc.) *
Please describe how you think this relationship is positively influencing both you and your mentee.
Do you have concerns regarding your mentoring relationship with your mentee? *
Do you need to speak with a Buffalo Prep Mentoring Supervisor? *
If yes, please enter the phone number to best reach you.
Please note any changes in your address, phone, email, employment, or personal information.
Additional comments or questions
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