Mentee Feedback Form IntroductionThe Katuka Mentorship Programme values your feedback to ensure the success and continuous improvement of the mentorship experience. Please use this form to provide structured feedback at the designated intervals. Your insights are crucial to achieving our shared goals. Feedback appraisals are due in April, July and October of each year.Page 1Page 2Page 3Page 4Page 5Page 6Mentee/Mentor DetailsDate*Mentee: Full NameFirstLastMentor: Full Name*FirstLastEmail address*NextGuidelines for Completing the FormKey Observations: Examples/Observations: Briefly describe any notable behaviours or situations (positive or negative) that significantly impacted the mentee’s progress or performance. Rate each dimension on a scale of 1-5 (1 = Poor, 5 = Excellent). Development Steps: Improvement Plan: Outline specific actions or strategies to address areas needing development or to build on strengths. Ensure these plans are measurable and time-bound.Goals & Objectives1. My mentor and I set clear and achievable objectives together (SMART goals).*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / Excellent2. My mentor is approachable and supportive.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / ExcellentBackNextGrowth & Development3. My mentor helps me develop new skills and knowledge.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / Excellent4. My mentor is actively engaged in my development.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / ExcellentBackNextEmotional Intelligence Development5. My mentor inspires and motivates me.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / Excellent6. My mentor maintains confidentiality and demonstrates integrity.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / Excellent7. I am satisfied with my mentor’s support and guidance.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / ExcellentBackNextStrategic Critical Thinking Skills8. My mentor encourages me to learn from mistakes.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / Excellent9. My mentor listens to my challenges and provides guidance.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / Excellent10. My mentor provides regular, structured feedback.*Your Rating*Never / DismalSeldom / PoorOften / AverageGoodAlways / ExcellentBackNextOverall AssessmentDescribe your mentoring sessions:*Have your mentoring goals been achieved? *YesNoIf No, what could be improved to support goal achievement?*New skills or knowledge gained:*Highlight any specific skills, knowledge, or insights you have acquired during this period.Additional comments:*Provide any other feedback or observations you’d like to share.BackSendThis field should be left blank
