CB 1:1: - Annual Survey - Mentor

Thank you for taking the time to complete our survey! Your answers will help us understand more about mentoring relationships and assist us in improving future programming.

Any information you provide to us, in connection with this evaluation, will remain confidential. We value your privacy and we will never share your name or individual answers with anyone. We will combine all survey responses together to find overall trends and suggestions for improving our program.

The survey will take approximately 8 minutes to complete.

Name(Required)
Please select the name of your Caseworker(Required)
Strongly DisagreeDisagreeAgreeStrongly AgreeNot Sure
Improved self-esteem and self-confidence
Opportunities to engage in the community
More positive attitude about school
Improved grades
Improved communication skills
Improved social skills
Improved relationships with family
Increased ability to make positive choices and decisions


How much conscious attention do you give to taking these actions with your Mentee? There are no right or wrong answers. Please answer as honestly as possible.
Express Care
Not YetRarelySometimesOftenAlmost Constant
Express Care
Challenge Growth
Not YetRarelySometimesOftenAlmost Constant
Challenge Growth
Provide Support
Not YetRarelySometimesOftenAlmost Constant
Provide Support
Share Power
Not YetRarelySometimesOftenAlmost Constant
Share Power
Expand Possibilities
Not YetRarelySometimesOftenAlmost Constant
Expand Possibilities
This field is for validation purposes and should be left unchanged.