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The Program Outcomes Evaluation is a chance for mentors to give their opinion on how the mach has progressed. Please be open and honest while completing this evaluation; this will aide us in identifying any areas of the match that may need to be addressed. All information and opinions shared on this form will remain confidential and will not be shared with the other match parties.

Please select one appropriate response for each item.

Match Region  

Mentor Name  

Child Name   

1. Self Confidence and esteem:                            

2. Able to express feelings:                                  

3. Can make decisions:                                       

4. Has interests or hobbies:                                   

5. Positive body image, appearance:                   

6. Sense of future:                                              

7. Uses community resources:                            

8. Academic performance:                                 

9. Attitude towards school:                                

10. School preparedness (homework):              

11. Class participation:                                      

12. Classroom behavior:                                   

13. Physical activity/ exercise:                           

14. Able to avoid delinquency:                         

15. Able to avoid substance abuse:                   

16. Able to avoid early parenting:                     

17. Shows respect towards you:                      

18. Respects others:                                        

19. Relationship with family:                             

20. Relationship with peers:                             

21. Relationship with other adults:                      

 

 

BBBS Troup (Northern Region)   1200 Fourth Ave.  P.O. Box 3630 LaGrange, GA  30241  Phone:(706) 298-2433 Fax:(706) 298-2412  msturdevant@dashlagrange.org

BBBS Columbus (Southern Region)  1350 15th Ave.  P.O. Box 1825 Columbus, GA 31902 Phone:(706) 327-3760 Fax:(706) 327-5750 emoore@familycenterofcolumbus.com

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