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Mentoring Program End of Year Survey
Please complete this brief survey to provide midterm feedback for your mentoring program experience. You will also be receiving an end-of-year survey in June as we wrap the program. Please also remember to save the date for June 11, 2011 at noon for a brief end-of-year celebration.
* Indicates required question
Email
*
Your email
How would you rate your experience in the WAN mentoring program?
*
Least Satisfactory
1
2
3
4
5
Most Satisfactory
How would you rate WAN mentoring program structure, expectations, and organization of orientation and end of year programs?
Least Helpful
1
2
3
4
5
Most Helpful
Clear selection
As a pair, how many times have you checked-in with your mentor or mentee?
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We did not have a chance to meet due to busy schedules or one party not being available
1-3 times over email only
1-3 times a combination of email, phone and virtual meetings
4-6 times a combination of email, phone and virtual meetings
7-10 times or more a combination of email, phone and virtual meetings
If you are a mentee, how would you rate your mentor's engagement and support?
Least satisfactory
1
2
3
4
5
Most satisfactory
Clear selection
As a mentee, to what extend have you met your goals in your action plan?
Not much progress
1
2
3
4
5
Met the goals in my action plan
Clear selection
As a mentee, please rate your self-perceived competency in the following leadership abilities in mentor-mentee interactions at the end of the year
Beginner in this skill set
Developing my abilities in this skills set
Confident in this skill set
Effective Communication
Active Listening
Receiving Feedback
Use of Adult Learning Methods
Cultural Responsiveness
Forming Relationships
Collaborative Goal Setting
Collaborative Problem Solving
Reflective Practice
Conflict Resolution
Following Up on Goals
Self-Evaluation
Beginner in this skill set
Developing my abilities in this skills set
Confident in this skill set
Effective Communication
Active Listening
Receiving Feedback
Use of Adult Learning Methods
Cultural Responsiveness
Forming Relationships
Collaborative Goal Setting
Collaborative Problem Solving
Reflective Practice
Conflict Resolution
Following Up on Goals
Self-Evaluation
If you are a mentor, how would you rate your mentee's responsiveness to your reach-out?
Least satisfactory
1
2
3
4
5
Most satisfactory
Clear selection
As a mentor, please rate your self-perceived competency in the following leadership abilities in mentor-mentee interactions at the end of the year
Beginner in this skill set
Developing my abilities in this skills set
Confident in this skill set
Effective Communication
Active Listening
Providing Meaningful Feedback
Use of Adult Learning Methods
Cultural Responsiveness
Forming Relationships
Collaborative Goal Setting
Collaborative Problem Solving
Reflective Supervision
Conflict Resolution
Following Up on Goals
Empowering Others
Beginner in this skill set
Developing my abilities in this skills set
Confident in this skill set
Effective Communication
Active Listening
Providing Meaningful Feedback
Use of Adult Learning Methods
Cultural Responsiveness
Forming Relationships
Collaborative Goal Setting
Collaborative Problem Solving
Reflective Supervision
Conflict Resolution
Following Up on Goals
Empowering Others
To what degree were you able to utilize mentoring program folder resources (recording of orientation, mentoring tips and strategies, templates)
Not much
1
2
3
4
5
Extensively
Clear selection
Would you like to serve as a mentor in next year's program (you can serve as mentor even if you were a mentee this year)? If so, please provide your email in the space provided.
Your answer
Any additional comments to elaborate on any of the questions above? Thanks for being part of a great experience! WAN Mentoring committee.
Your answer
Send me a copy of my responses.
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