ATP Education 115B Mentor Feedback Form Updated on: August 30, 2021 Name of Host Teacher First Last Grade Name of AC Mentor First Last Mentor area: (check all that apply) Recess/Lunch Buddy Academic Support Art Support Social/Emotional Support Other If other, please specify: Rate the Mentor on a scale of 1 to 5 for the following areas: (1 - needs improvement to 5 - exceeded expectations)Arrived at the scheduled time 1 2 3 4 5 Arrived every week (or notified teacher if unable to make it) 1 2 3 4 5 Was attentive to assigned student 1 2 3 4 5 Acted appropriately 1 2 3 4 5 Provided encouragement and support 1 2 3 4 5 Followed dress code 1 2 3 4 5 Other comments: