Free
https://docs.google.com/document/d/14cobpssqegLEe2JGPLYPAazwbD3lByjmexX-yULwzls/edit?usp=sharing
Launched 12/04/2021
Parent Mentorship Program
Model and Techniques
MENTORING AGREEMENT
PURPOSE
This mentoring agreement is to ensure both mentor and mentee are aware of the process and expectations of the relationship. Identifying the goals and challenges throughout the process.
Mentee
I _____________________________________agree to
1.Honour meeting dates and time and communicate frequently
2.Look at various ways to help with my well being
3.Revisit and keep a log of my progress while working towards my goal
4.Ensure confidentiality is maintained throughout the relationship
Mentor
I _______________________________________agree to
1.Be responsible
2.To provide support and encouragement and feedback of progress to mentee..
3. Meet in person to maintain relationships and help to identify goals.
4. Maintain confidentiality
This agreement signed today outlines goals and expectations between mentor and mentee listed below. Current plan is in place to revisit this document from time to time.
Next review date is ________________________ this is so to refresh goals and challenges accomplished.
Mentor name _________________
Mentor signature/or electronic______________Date ___/____/______
Mentee name _________________
Mentee signature/or electronic _____________Date____/____/______
PARTICIPANT INFORMATION
Mentee
Name ______________________
Address : Street _______________City__________Post Code______
Phone number:_____________________Email:________________________
Mentor
Name _______________________
Address : Street _______________City___________Post Code______
Phone number:_____________________Email:________________________
MENTORING ACTION PLAN COMPLETED:
*DATE PLANNED
**UPDATE
***SIGNATURE MENTEE
****SIGNATURE MENTOR
FREQUENCY OF MEETINGS
___________________________________________________________________________________________________________________________________________________________________________
SCHEDULE OF MEETINGS (TELEPHONE/WEB/IN PERSON)
__________________________________________________________________________________________________________________
_________________________________________________________
GOALS
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
NEED
ACTION PLAN
notes:______________________________________________________________________________________________________________________________________________________________________________________
MENTEE EVALUATION PROGRESS
Date of Evaluation ___________________________________ Year of Evaluation___________________
MET GOALS (YES/NO/COMMENTS)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
MENTEE SELF ASSESSMENT
All the time
Some of the time
Not too often
Almost never
never
I showed respect to my mentor
I turn up to all meetings
I understand my responsibility to make progress
I was open about my experiences
I accepted feedback given
I display courtesy on all levels
I am happy with the trust we built
I offered ways to improve my well being
If I cancelled a meeting I gave well enough notice
I respected opinions shared
I understood the level of confidentiality shared
I was motivated in each session
EVALUATION OF MENTOR
All the time
Some of the time
Not too often
Almost never
never
Did your mentor show respect to your emotions?
Did your mentor show up to all meetings?
Did your mentor show responsibility in your progress?
Did your mentor share experiences that help you?
Did your mentor give feedback after each meeting?
Did your mentor display courtesy on all levels?
Was your mentor happy with the trust built?
Did your mentor offer ways to improve your well being?
If a meeting was cancelled did you receive enough notice?
Did your mentor respect your opinions shared?
Did your mentor talk about the level of confidentiality ?
Did your mentor motivate and encourage you in each session?
REVIEW
Comments:
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Suggestions:
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