NOTIFICATION OF COMPLETION OF MENTORING PARTNERSHIP

TO BE COMPLETED BY MENTEE

I (name of mentee) ______(ADEA Membership Number) ______am advising ADEA that the mentoring partnership with ______(name of mentor) was completed by mutual agreement on _____ / _____ / _____.

I have maintained copies of relevant documentation to substantiate my involvement in the mentoring partnership including a record of contacts between me and my mentor.

Signature:______Date: _____ / _____ / ______

EVALUATION

Your answers to the following questions will be used to evaluate and improve the ADEA Mentoring Program. They will not be used as a means of assessing either your achievements within the partnership or your mentor’s role in the partnership.

Please complete the following pages and forward them to the ADEA National Office together with this page.

EVALUATION

  1. Please indicate on a scale of 1 – 5 to what extent you believe the overall goals of your mentoring partnership were achieved.

12345

Not at allExtremely well

Comments: ______

  1. Was this partnership dissolved earlier than originally anticipated?

 Yes No

If yes, what was the reason?

 Mentee goals were achieved earlier than anticipated

 Partnership was unsatisfactory and dissolved by mutual agreement

 Other: please specify: ______

  1. Please indicate on a scale of 1 – 5 to what extentyour personal goalsforthe mentoring partnership were achieved.

12345

Not at allExtremely well

Comments: ______

  1. Did you contact the ADEA National Office for support regarding the mentoring program at any time?

 Yes No

If yes, please indicate on a scale of 1 – 5 how you would rate the support your received from the ADEA National Office

12345

Very poorExcellent

Comments: ______

  1. How would you rate the mentoring program material in the ADEA Mentoring Program Members Manual?

12345

Very poorExcellent

Comments: ______

  1. How did you find your mentor?

 ADEA website

 Branch representatives

 Own network and contacts

 Other: (please specify): ______

Comments: ______

  1. Did you enter a mentoring partnership in order to become credentialled?

 Yes No

If yes, have you submitted a credentialling application?

 Yes No

If no, do you intend to submit a credentialling application?

 Yes No

Comments: ______

  1. Please indicate on a scale of 1 – 5 how you would rate your overall satisfaction with the implementation of the ADEA Mentoring Program?

12345

Very poorExcellent

Comments: ______

  1. Would you act as an ADEA mentor in the future?

 Yes No

Comments: ______

  1. Please write any other comments or suggestions regarding the ADEA Mentoring Program?

______

Thank you

This Notification of Completion and Evaluation must be submitted to the ADEA National Office within two (2) weeks of completing the mentoring partnership.

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