Sample Mentoring Program Coordinator Weekly Tracking Form
SAMPLE MENTORING PROGRAM COORDINATOR SUMMARY
WEEKLY ACTIVITY TRACKING REPORT
Program Coordinator Completing Form: ________________________________
Report Date: _______________________ Reporting Period: _______________
|Mentors Submitting Weekly Reports |Number of mentors submitting reports |
| |Number of weekly reports submitted |
| | |
|Mentees Reflected in Weekly Reports |Number of mentees |
| | |
|Number of Mentees Tracked Per Targeted |Antisocial Behavior |
|Behavior |Family Problems |
| |Social Competence |
| |Gang Involvement |
| |Alcohol and Drugs |
| |School Attendance |
| |High School Graduation |
| |Low Grade Point Average |
| |Perceived Access to Social Services/Support |
| | |
|Mentors Indicating Changes in Targeted | |
|Behaviors |_____ Number of mentors indicating changes in behaviors |
| | |
|Number of Mentees Who Participated in or |Participated |Completed |
|Completed Evidence-based Programs |Project Learn |Project Learn |
| |SMART Leaders |SMART Leaders |
| |Gang Prevention Through Targeted Outreach|Gang Prevention Through Targeted Outreach |
| | |
|Mentees Who Participated in BGCA-approved |_____ Number of mentees who participated in BGCA- |
|Programs or Activities | |
| |approved programs or activities |
| | |
| | |
|Mentees Who Participated in Other Activities |_____ Number of mentees who participated in other activities |
|or Events |or events |
| | |
| | |
|Challenges, Issues or Concerns |List of challenges, issues or concerns: |
| | |
| | |
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