Mentoring Questionnaire
Please answer the following questions fully and honestly in order for you to be correctly matched with a mentor.

M2 Mentoring Student Questionnaire

General Information

Tell us about yourself
I am smart.It is hard for me to make friends.I get worried when we have tests in school.I am disciplined.I am slow in finishing my work.I wish I were different.I can be trusted.I lose my temper easily.I am sick a lot.I am attractive.I am good at my school work.I often get into trouble.I am easy to get along with.I am often late to school.I like being alone.

Agree or Disagree

As a willing participant in the Mentor Program, I commit to working with my mentor through the duration of the program, attending all scheduled meetings with my mentor, and communicating weekly with my mentor. Emergencies happen to all of us. Should I be unable to keep a meeting with my mentor, I shall call in advance to reschedule. I agree to develop personal goals with my mentor and to be open to coaching and feedback from my mentor. In the event that I wish to discontinue my match for any reason, I will first notify the (Mentoring Coordinator/Program Director, etc), and discuss this before discontinuing.

For more information:
Jamal McMillion
Minority Male Success Initiative Coordinator

Administration (Building 003), Room 140G
Phone: (252) 527-6223, ext. 343
Fax: (252) 233-6867