This is only a SAMPLE of what the real survey will look like. Please do NOT distribute this version of the survey to constituents of your program.

If you are interested in using the Vermont Mentoring Surveys for your program, please email benji@mobiusmentors.org to receive your unique survey links.

[Program Name/Info Here]

Question Title

* Mentee ID Number:

Question Title

* I will introduce my mentee to people he/she may not meet otherwise.

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* I will notice positive changes in my mentee during the time that we are matched.

Question Title

* I feel I have the support and training I need at this time.

Question Title

* Which best describes the role you plan on taking in your mentee’s education? (check all that apply)

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