BOM MENTOR-FACILITATOR EVALUATION FORM

Mentor-Facilitators should complete this form together

Resident’s Name: Date

Current Year in Residency  First  Second  _____
Mentor’s Name: Phone #
Mentor’s E-mail:
*****
Mentor’s Name: Phone #
Mentor’s E-mail:
This form is filled out by the Assigned Mentors, who should mail it to the Chairperson of the Residency Committee of the Conference BOM
by January 31. You may also attach a letter or documentation if you believe it will assist the BOM in its process.

1. How has the resident been involved in the CPG? Attendance? Sharing?

2. Please share any additional information you think would be helpful to the Board of Ordained Ministry in
preparation for Spring Interviews:

3. Do you have any concerns that would stop you from recommending the resident..
a. To continue in the residency program? (for residents seeking continuance)
or
b.. To be ordained at Annual Conference? (for residents applying for Full Connection)

No Concerns Yes, I have concerns as follows:

Thank you for your part in the Board of Ordained Ministry evaluation process.
MAIL TO: Rev. Blake Bradford, revbradford@gmail.com, by January 31