Mentee Interest Survey - PCSAO Peer Mentoring Program.pdf
Mentee Interest Survey - PCSAO Peer Mentoring Program.pdf
Mentee Interest Survey - PCSAO Peer Mentoring Program.pdf
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<strong>PCSAO</strong> <strong>Peer</strong> <strong>Mentoring</strong> <strong>Program</strong><br />
<strong>Mentee</strong> <strong>Interest</strong> <strong>Survey</strong><br />
The following questions will help us learn more about you and help us find a mentor that is just right<br />
for you.<br />
Name:<br />
______ Age:<br />
Gender: _____ Male _____ Female<br />
1. When is the best time and day for you to attend group activities with your mentor?<br />
Check as many as you want:<br />
_____ Saturday morning<br />
______Sunday afternoon<br />
______Saturday afternoon<br />
______All of these times are fine<br />
2. Tell us about your school:<br />
School Name<br />
____________ Grade<br />
What are your favorite subjects in school?<br />
What subjects do you have trouble with?<br />
____________<br />
____________<br />
3. What do you like to do after school? What sports or activities are you involved in?<br />
4. What is one goal you have made for your future?<br />
5. If you could learn about a job/career what would it be?<br />
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<strong>PCSAO</strong> <strong>Peer</strong> <strong>Mentoring</strong> <strong>Program</strong><br />
6. If you could learn something new, what would it be?<br />
7. What person do you most look up to and why?<br />
______<br />
8. Describe your ideal Saturday:<br />
9. Please check all the activities you do or might like to do with your mentor:<br />
_____ Movies _____Tutoring _____ Hiking<br />
_____ Music _____ Sports _____ Reading<br />
_____ Eating out _____ Sport events _____Miniature golf<br />
_____ Parks _____ Animals _____ Cooking<br />
_____ Arts and craft _____ Board Games _____ Shopping<br />
_____ Bowling _____ Theatre/plays _____ Museums<br />
_____ Video games / Computer _____ Community Service Projects<br />
_____ Roller skate / Ice skate _____ Other ideas _________________________________<br />
10. What qualities would you like your mentor to have?<br />
11. Anything else you would like your mentor or our staff to know about you?<br />
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