Republic of the Philippines

Department of Education
Region IV-A CALABARZON
DIVISION OF BATANGAS
LUCSUHIN NATIONAL HIGH SCHOOL

MENTORSHIP EVALUATION AND FEEDBACK FORM

(Mentor Evaluating Mentee)
(Completed by the Mentor)

Please provide information and insight by indicating a rating value for the following questions related to the activities of the
mentoring process.

Mentor’s Name: MARICHELLE C. CALINGASA Quarter:

Mentee’s Name: RHONA D. VILLANUEVA Semester:
A. Directions: Check () the selection box per questions which best describes your opinion regarding your mentor.

QUESTIONS YES NO MAYBE DON’T NOT

KNOW APPLICABLE
1. Was your mentee easy to approach and talk with? 
2. Did you facilitate your mentee’s participation in 
professional activities?
3. Did you and your mentee complete the goals planned? 
4. Did you encourage / help your mentee develop research 
ideas and push him / her to write on it?
5. Did/ Do you provide regular feedback and constructive 
criticism?

B. Direction: Check () the selection box per questions which best describes your opinion as mentor

Strongly Strongly
Agree Disagree
Mentoring Criteria Agree Disagree
1. My mentee respected my time and professional
responsibilities 
2. My mentee made use of feedback provided throughout
the mentoring relationship. 
3. My mentee demonstrated a reasonable interest / concern 
towards me in my quest to offer assistance.
4. My mentee was concerned about academic problems and 
worked to remove deficiencies.
5. My mentee communicated regularly with me. 

C. Please respond to the following statement using the scale provided.

A. My mentee effectively uses time to ensure developmental goals are met.

Never / 1_________2__________3___________4____________5___________ / Always

B. Overall satisfaction with mentoring

Additional Comment:
Ineffective / 1_________2__________3___________4__________5__________/ Effective
Mentor Signature ____________________ Date: __________

Address: Lucsuhin, Calatagan, Batangas 4215

(043) 419 – 007
lucsuhinnational@gmail.comRepublic of the Philippines
Department of Education
 DIVISION OF BATANGAS
LUCSUHIN NATIONAL HIGH SCHOOL

MENTORSHIP EVALUATION AND FEEDBACK FORM

(Mentor Evaluating Mentor)
(Completed by the Mentee)
Please provide information and insight by indicating a rating value for the following questions related to the activities of the
mentoring process.

Mentor’s Name: MARICHELLE C. Quarter:

CALINGASAN
Mentee’s Name: RHONA D. VILLANUEVA Semester:
Directions: Check () the selection box per questions which best describes your opinion regarding your mentor.

Strongly Agre Strongly

Disagree
Questions Agree e Disagree
1. My mentor demonstrated a reasonable interest / concern

towards me.
2. My mentor was accessible and available. 
3. My mentor communicated regularly with me. 
4. My mentor’s behavior and attitude generally is an example of

Professionalism
5. My mentor assisted me with my understanding of the academic

routes to achieve my goals.
6. My mentor assisted me with improving my course work

performance.
7. My mentor assisted me with my queries. 
8. I learned at least one important lesson about my career or

Professionalism from my mentor.
9. My mentor acknowledge my professional contributions. 
10. My mentor accurately estimated my ability to conduct research. 

B. Please respond to the following statement using the scale provided.

A. My mentor provides appropriate feedback in a constructive manner.

Never / 1______2________3________4________5________/ Always

B. My mentor is aware of available development offerings and can identify valuable opportunities to improve my competency

Never / 1______2________3________4________5________/ Always

C. Overall satisfaction with mentoring

Ineffective / 1_______2_______3______4________5 _______/Effective

Additional Comments: She is a very good mentor and approachable person.

_________________________________________________________________________

Mentee Signature __________________

Address: Lucsuhin, Calatagan, Batangas 4215

(043) 419 – 007
lucsuhinnational@gmail.com