Mentee / Mentor Evaluation Form

You are a Mentor or a Mentee

In the Field of: Water Wastewater or Both

Contact Information:

Name:

Organization:

Mailing Address:

City: Zip Code:

Telephone:

Email Address:

Mentorship Information:

Date of Mentorship:

Area of Mentoring:

Summarize What Was Accomplished:

Goal(s) of Mentee:

Were the goals of the Mentee met? Yes    No
If no, why not?

Was it a positive experience? Yes    No
If no, why not?

What can be done to improve the Mentoring Program?

Would you like to participate in the Mentoring Program again?
Yes    No

Other Comments: