Copy of page:

* 1. Identification

* 2. When did your meeting take place?

Date & Time

* 3. How long did your meeting last?

* 4. Where did the meeting take place and what was done during the meeting time? (i.e. we met for coffee at Einstein's)

* 5. Please give a brief overview of topics discussed.

* 6. Please provide a brief reflection of how the meeting went.

* 7. Are there things that could be improved in order to make the next meeting for beneficial?

* 8. Are their issues or concerns that the Mentoring Program Coordinator should follow up with this person about?