GOVERNMENT OF KARNATAKA GOVERNMENT FIRST GRADE COLLEGE COX TOWN, FRAZER TOWN POST, BENGALURU- 560 005 Phone: 080-25468522                                       Email:gfgcfrtn05@gmail.com

                                                                                                     MENTOR-MENTEE FORM 

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NAME OF THE MENTEE                 : …………………………………………………………………..

COURSE / COMBINATION            : …………………………………………………………………..

REGISTER NUMBER                         : …………………………………………………………………..

PERIOD OF REPORT                        : …………………………………………………………………..

GENDER: M/F                                   : …………………………………………………………………..

Guidelines:

The Mentor-Mentee system has been introduced with the ive of recording a meaningful evaluation of a student’s performance and making available a support system within the college for the student. The resulting testimonials are aimed at assisting the student in his/her career and future endeavours.

While maintaining this record, the Mentor is expected to help her ward and keep track of the ward’s overall progress to the college. The personal data recorded herein will be treated as CONFIDENTIAL. Student should feel free to share the information of academic and personal life to Mentor which influences his/her all round development.

For the student, the Comprehensive Personal record is going to serve as a dependable testimony of his/her abilities and potentialities to be utilized to his/her advantage. A student is expected to treat this record as invaluable and regard the Mentor as confident. An honest evaluation can only be arrived at if the student is truthful about the information he/she has imparted.

The Mentor-Mentee Certificate, given at the end of the course to students, will enable a prospective employer or an institution of higher learning to secure brief estimate of the candidates placing in the institution. The grading on conduct is given gauging the overall performance of the ward. Student’s evaluation by the Mentor would be on the following criteria.

v  Punctuality & Regularity

v  Leadership Qualities

v  Creativity

v  Positive Attitude

v  Sense of Responsibility

v  Team spirit

v  Sense of commitment

v  Inter-personal Skill

Keys to grading

Excellent     : A+ Very Good : A Good            : B Satisfactory: C

A positive attitude on the part of the student and the Mentor would forge a record of reference, reflecting the most formative years of a student’s life.

I PERSONAL DETAILS

1.   Name of the Student                     : ………………………………………………..

2.      Admission No/Year                       : ………………………………………………..

3.   Reg. No.                                               : ………………………………………………..

4.      Communication Address            : ………………………………………………..

………………………………………………………………………………………………….

5.   Telephone Number/Mob-No.   : ……………………………………………….

6.      E-Mail ID                                            : ……………………………………………….

7.   Date of Birth & Age                         : …./…../………/ &………….. Nationality: ………………………………

8.      Blood Group                                     : …………………………………..

II FAMILY INFORMATION

Name: ………………………………………………… Course: ………………………………….. Year: ………………….

11. Staying                   With Parents

Hostel

Relatives

12. Guardian Name & Address                          : ……………………………………………………………………………

13. Relationship with Guardian                        : ……………………………………………………………………………

14. Mode of Transport                                          : ……………………………………………………………………………

15. Special Interest & Hobbies                         : ……………………………………………………………………………

Mentee Signature                                                                                                     Parent Signature

Mentor Signature                                                                                                      Principal Signature

III ACADEMIC PROGRESS

1.     ATTENDANCE RECORD-I YEAR

II                                                                                                                                                                      YEAR

III                                                                                                                                                                     YEAR

1. INTERNAL AND EXTERNAL EXAMINATION