Connecting Generations

Teacher’s End of Year Survey
Thank you for participating in the mentoring program and for taking the time to complete this survey. It’s very important in helping us to assess the impact mentoring has had on your student this school year. Please fill out and submit this form as soon as possible.
School   Date:  7/4/2009
Teacher’s Name   Student’s Grade  
Student’s Name   Student’s Gender  M   F
Mentor’s Name   Mentor’s Gender  M   F
Please indicate if this was this student’s first year in the mentoring program.
Yes   No
If No, did this student have the same mentor this year as in previous years?
Yes   No
1.   What were your impressions of your student’s feelings about the mentoring experience? Please check all that apply.
  My student and his/her mentor became special friends.
  My student looked forward to his/her mentoring sessions.
  Mentoring had a very positive effect on my student.
  Being mentored helped my student feel good about him/herself.
  My student didn’t seem very interested in being mentored.
  My student wanted a mentor, but didn’t seem to like the mentor he/she was assigned.
  My student was disappointed in his/her mentor because he/she couldn’t count on the mentor being there every week.
2. Would you recommend that your student be part of next year’s program?
  Yes   No   Uncertain
Please check all that apply:
"Yes" reasons...
I hope my student can continue with the same mentor next year.
I would like my student to have a different mentor.
My student needs a mentor to be the same gender as he/she is.
My student needs on-going and consistent support and encouragement that mentoring provides.
My student needs and benefits from the extra attention one-on-one mentoring provides.
Mentoring helps my student’s self esteem.
My student is “opening up” as a result of being mentored.
My student benefits from having a same gender role model.
My student has taken a more positive interest in school since being mentored.
I believe that having a mentor helps my student do better in school.
It’s good for my student to have another adult he/she can talk to.
"No" reasons...
My student didn’t seem very interested in being mentored.
I feel the time out of class has hurt my student academically.
My student is moving out of the area.
 
Other Comments:

Please consider how you feel the mentoring relationship has affected your student over the course of this school year and check the column that best reflects the change you have noted.
  Much Better A Little Better No Change A Little Worse Much Worse Do not Know Not a Problem
CARING              
Shows Trust Towards You
Shows Respect for Adults
Respects Other Cultures
Relationship with Family
Relationships with Peers
Relationship with Other Adults
  Much Better A Little Better No Change A Little Worse Much Worse Do not Know Not a Problem
Personal Growth              
Self Confidence
Self Control
Cooperation
Responsibility
Able to Express Feelings
Can Make Decisions
Thinks Before Acting
Classroom Behavior
Has Interests or Hobbies
Personal Hygiene/Appearance
Able to Avoid Delinquency
Able to Avoid Substance Abuse
Sense of the Future
  Much Better A Little Better No Change A Little Worse Much Worse Do not Know Not a Problem
Competence              
Attendance
Initiative
Pays Attention
Follows Directions
Attitude Towards Learning
Completes Assigned Tasks
Class Participation
Works Independently
Works Well with Others
School Preparedness (homework)
Academic Performance - Reading
Academic Performance – Math
Academic Performance – Language Arts

Has there been any improvement in the student’s grades, in any school subjects, since the beginning of the school year? (Please choose)
Yes  No
If yes, in how many subjects have you observed an improvement in grades? (Please choose)
1     2     3     4 or more
Thank you for completing our survey.