Mentor Monthly Report

The monthly Mentor Report is due by the 15th day of the month, reporting for the previous 15th through 15th period.

For questions, contact Mentor Coordinator, Dan Drover, at (208) 464-1467.

* Indicates required field

Cadet Name:*

Mentor Name:*

Email:*

Did you have at least 4 hours of contact with your Cadet this past month?:*
YesNo

Contact Date 1:

Contact Type 1:

Contact Date 2:

Contact Type 2:

Contact Date 3:

Contact Type 3:

Contact Date 4:

Contact Type 4:

Contact Date 5:

Contact Type 5:

Additional Information:*

Please check all boxes that best describes what your Cadet has been doing during the reporting month. Please enter the dates that he/she enrolled in school, enlisted in a military service/shipped, or began working. Also, include a school/work/recruiter phone number, so we may verify.

Post-Residential Placement Activity:*
Return to High SchoolVo TechCollegePart-Time EmploymentFull-Time EmploymentJob CorpAdult EducationArmyNavyMarinesAir ForceCoast GuardNational GuardCare GiverHomemakerIncarceratedDisabledHospitalizedMoved Out-of-StateDeceasedArrest/ViolationsOtherUnknown

Start Date:

Verification Phone: