2007 DMD 
Mentee Evaluation Form


   

Thank you for participating in Disability Mentoring Day 2007!  In order to continue to improve next year’s event, we would appreciate it if you would complete this brief evaluation form and return it to us by ________________________.  


      Please                     the appropriate ranking for each statement below based on the following scale:

              5 – Strongly Agree      4 - Agree     3 - Neutral     2 - Disagree     1 – Strongly Disagree
                  

1. I felt well-prepared prior to DMD								         5		4		3		2		1 

2. The DMD event was well-planned and organized 			               5		4		3		2		1

3. The opening session “fired me up” for my day of mentoring	               5		4		3		2		1

4. I felt that I had enough time with my mentor during DMD                    5		4		3		2		1

5. DMD helped me learn more about my chosen future career			  5		4		3		2		1

6. I enjoyed my DMD experience and would do it again				  5		4		3		2		1
7. Would you like to participate in next year’s DMD scheduled for October 17, 2007?    ? Yes  ? No  

   If yes, please print your name below so we can keep your record active in our database:


8. What did you like most about DMD?
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. What did you like least about DMD?
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

10. How can we make next year’s DMD experience better?
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

11. Would you like an AAPD representative to call you about your DMD experience?    ? Yes  ? No  
	If yes, please print your phone number/ best time to call you: ____________________________


Please complete by November 1 and fax to (___) ___-____ OR return via mail to:

[Local Coordinator Name], [Organization Name]
[Organization Address], [City], [State],   [Zip]
	
American Association of People with Disabilities (AAPD)
1629 K Street NW, Suite 503, Washington DC 20006
V/TTY: 202-457-0046/800-840-8844 * Email: dmdaapd@aol.com * www.dmd-aapd.org