Mentor Feedback Form

The tangent planes referred to in this questionnaire are those dimensions of behaviour that impact significantly on a mentee’s effectiveness. Each tangent plane is measured on a scale of 1 to 5. Please use the following guideline when awarding a mark:

5 = Excellent performance
4 = Above average performance – satisfying of higher order needs are necessary
3 = Average performance with room for improvement
2 = Below standard performance – development plans are essential
1 = Poor performance – development plans are crucial.

In addition to the mark, critical incidents relating to both positive performance as well as grey areas relating to that specific dimension needs to be jotted down.
If a behavioural dimension needs to be developed, a plan of action needs to be agreed upon with the mentee. These plans of actions need to be measurable in terms of time and output required.

If the mentor needs to make any other comments, these may be jotted down in the Comments column.

Both mentors and mentéés are required to submit a feedback appraisal form to the Katuka Programme Officer in March, May, July, September and October of each year.

General comments and additional notes.