HARVEST INTERNATIONAL SCHOOL

Dear Student,

The Student Mentorship program enables constructive interaction, guidance and mentorship for
students by their teachers (mentor). Mentoring is a particular form of relationship designed to
provide personal and professional support to you. The mentor is generally more experienced than
the mentee and makes use of that experience in a facilitative way to support and promote the
development of the mentee. The mentoring relationship provides a developmental opportunity for
both mentor & mentee and can thus be of mutual benefit. In a nutshell, a mentor's role may be
perceived to be facilitative, supportive and developmental for you. Kindly fill this form .

1. Full Name

2. Grade

3. Home Address

4. Mobile No

5. Email id

6. Name of the Father and email

id

7. Name of the mother and

email id

8. Occupation of the parents

9. Type of Family (Joint /

Nuclear)

10. Languages you know: Read:

Write:

Speak:

11. Your birthday

12. Briefly describe your

personality

13. What are your career

aspirations?

14. What are you looking for in a

mentor and what are you
hoping to gain from the

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 mentoring program?

15. What are your strengths?

16. What is your weakness?

17. Describe the personality of a

person or people with whom
you get along well:

18. What special interests,

hobbies, or leisure activities
do you enjoy when you’re not
in school.

19. Specify what time of day you

are available to meet-short
break/lunch break or any
other specific time in school
for 10 min

20. Please share any additional

information about yourself
which can help to know you
better

Finish the sentence below. No answer is right or wrong.

I really feel connected when

I feel angry when _

A job or task that I really

enjoy is

I feel hurt when __

What is the most important

thing that you think your
mentor should know about
you?

Mentee signature: _________________________________________ Date: _______________

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