Checkpoint
For Tier 3a Mentees
To be completed by the mentor during the middle of the semester.
Circle
1. Are you on track to graduate within the next 3-4 semesters?
Yes/No
2. Have you taken the majority of your pre-requisite classes for your health program?
Yes/No
3. Are your grades marketable for your health program?
Yes/No
4. Do you feel confident about your marketability?
Yes/No
5. Are you proud of your successes?
Yes/No
6. Are you a leader in a student organization?
Yes/No
7. Mentee: What extracurricular activities are occurring this semester that you have or will be participating
in?
8. Mentor: What advice do you have about 1-7 above?
Mentee name & date: ______________________________ (print); ___________________________(signature)
Mentor name & date: ______________________________ (print); ___________________________(signature)