Mentor Report

 
Mentee's Name: *      
Mentee's Telephone:
Class #     
Mentee Mailing Address:
 
Mentor's Name: *     Mentor's Email:
Mentor's Telephone: *   Best Time to Call:
Mentor Mailing Address:

Have you had 4 Hours of contact with your Cadet this month?  Yes No

Date of Contact Phone Face to Face Other Comments
 * 
 * 
 * 
 * 
    
Employment:      > Part Time         > Full Time
Date of Hire:     
Employer's Name:      Wages:
Supervisor's Name:    Phone:
Employment Notes:         
      
Continuing Education:
         > Part Time   > Full Time
               
    Type:
         > Votech > College
> Job Corps > Adult Eductaion
> None
Date of Enrollment:              
Name of High School:              
GED:          Yes >         No >       Date:
Education Notes:         
    
Military Service:
> Active Duty > Reserves   
> National Guard   
                         
Branch:
         > Army > Navy    
         > Air Force > Marines
         > Coast Guard  
Enlistment Date:              
Delayed Entry Date:              
Recruiter's Name:              
Recruiter's Number:              
Current Military Address:          
Rank:              
Military Notes:              
    
Other:
> Caregiver > Volunteer
> Homemaker > Seeking Employment
> Deceased > Moved Out of State
> Incarcerated > Law Violations
> Disabled/Hospitalized > Self-employed
> Apprenticeship > Unknown
    

Comments:

Include Mentor or Mentee's change of address or telephone number, good news, concerns, etc.

    
      
                          
       
      

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