IMP 16-17 Q4 Report

1. Quarterly Reports for Mentoring Programs (Q4, 16-17)

50% of survey complete.

Thank you for taking the time to complete the Iowa Mentoring Partnership's Fiscal Year 2016-2017 Quarter 4 Report. For this survey, please report on the months of April, May, and June of 2017 no later than Monday, July 31, 2017.

Completion of the IMP Quarterly Report ensures your program's continued certification status.

Every Monday until the due date, the IMP Director will send verification to programs that their report was received.

If you wish to retain a copy of your quarterly report, please print this page for your records before advancing the page and submitting the survey.

If you have any questions or concerns please e-mail Mary Sheka at mary.sheka@iowaeda.com

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* 1. Name of your mentoring program:

Other (please specify)

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* 2. Name of person completing this report:

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* 3. Please provide your e-mail in order to send verification of report receipt (please use primary IMP contact information)

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* 4. Current number of active mentoring relationships in your program:

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* 5. Current number of youth accepted to the program and waiting to be matched:

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* 6. Number of new mentoring relationships your program started in April, May and June 2017:

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* 7. Number of matches closed in your program during the months of April, May and June of 2017:

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To retain a copy of your responses, please print this page before proceeding.