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Closure Survey – Caregiver

CB 1:1: - Closure Survey - Caregiver

Thank you for taking the time to complete this survey! There are no right or wrong answers, so please be honest. It will help us strengthen our program and provide data to demonstrate the effects of mentoring on children and youth. All the data from this survey will be kept anonymous. 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 5 minutes to complete.

Name(Required)

First Last

Child's Name(Required)

First Last

Please select the name of your Caseworker(Required)

Devinder Budhram

Dominica Hannaford

Jen Dalziel

Sophie Mercer

Sue Kowalchuk

Tara Paterson

I feel that my child has grown in the following areas:(Required)

	No change	Strongly disagree	Disagree	Agree	Strongly agree
Improved self-esteem and self-confidence
Opportunities to learn new skills and have new experiences in the community
Increased sense of happiness and hope for the future
More positive attitude towards school
More involvement with school activities
Improved communication and social skills
Improved relationships with peers
Improved relationships with family
Increased ability to make positive choices and decisions

How does your child feel about the match closing?(Required)

How has your child benefited from the match?(Required)

What is your general assessment of the match?(Required)

Poor	Somewhat Positive	Positive	Very Positive

What characteristics did your child's Mentor have that you felt made them a good role model?(Required)

What difficulties or challenges did the match experience during their time together?(Required)

Unable to provide consistent outings

Communication to arrange and confirm outings

Felt they did not have common interests

No difficulties or challenges

Other

If you indicated a challenge above or indicated 'Other', please provide details below.

If you have any suggestions for making the program more successful, please provide details below.(Required)

Would you like your child to be re-matched?(Required)

Yes

Maybe

If 'Yes', what program would you prefer for your child?

1:1 Match

BCAC Match (Black Mentor is matched with a Black Youth)

Group Mentoring

Name

This field is for validation purposes and should be left unchanged.