Mentor Report Mentor Report Please enable JavaScript in your browser to complete this form. - Step 1 of 6Platoon Case Manager *Select a Case ManagerSSG Armando BernalCPL Ariana GonzalezSSG Tina ScrudatoSrA Jeremy AdamsReporter *FirstLastReporting Period *Select a Time PeriodJan 1 to Feb 1Feb 1 to Mar 1Mar 1 to Apr 1Apr 1 to May 1May 1 to June 1June 1 to July 1July 1 to Aug 1Aug 1 to Sept 1Sept 1 to Oct 1Oct 1 to Nov 1Nov 1 to Dec 1Dec 1 to Jan 1Mentee Name *FirstLastMentee Phone Number *Class Number *Please Choose One4950Mentor Name *FirstLastMentor E-mail *Mentor Phone Number *NextCONTACTSFIRST CONTACTType of ContactChoose Contact MethodE-mailFacebookLetterOffsite VisitPersonal ContactPhone CallText MessageOtherDate of ContactCommentsSECOND CONTACTType of ContactChoose Contact MethodE-mailFacebookLetterOffsite VisitPersonal ContactPhone CallText MessageOtherDate of ContactCommentsTHIRD CONTACTType of ContactChoose Contact MethodE-mailFacebookLetterOffsite VisitPersonal ContactPhone CallText MessageOtherDate of ContactCommentsFOURTH CONTACTType of ContactChoose Contact MethodE-mailFacebookLetterOffsite VisitPersonal ContactPhone CallText MessageOtherDate of ContactCommentsNextMENTEE INFORMATIONEmploymentPlease Select OnePart-TimeFull-TimeSelf-employedPlease Select OneYesNoDate of HireHours worked per weekEmployer's NameSupervisor's NamePhoneRateWage TypePlease Select OneAnnualBi-annualCommissionHourlyWeeklySalaryWork StatusPlease Select OneDeployedPart-timeFull-timeRetiredTemporaryUnemployedVolunteerDate of Termination (if applicable)CommentsNextContinuing EducationPlease Select OnePart-TimeFull-TimeSchool TypePlease Select One2-year college4-year collegeAdult educationAlternativeChalleNGeCharterHigh schoolJob corpsMagnetNCCCPrivateVo techOtherDate of EnrollmentInstitution's NameStatusPlease Select OneDid not passDropped outEnrolledGraduatedSuspendedDate of Completion (if applicable)GEDPlease Select OneYesNoCHSPEPlease Select OneYesNoCommentsNextMilitary ServiceActive DutyReserveNational GuardRetiredBranchArmyNavyAir ForceMarinesCoast GuardNational GuardAir National GuardEnlistment DateDelayed Entry DateRecruiter's NameCurrent Military AddressRankCommentsNextMAP ChangesPlease Select OneYesNoDescribe the changesExplain the expected outcomeExplain why the cadet made this changeProvide comments or concerns regarding the changeOtherCaregiverVolunteerHomemakerSeeking employmentDeceasedMoved out-of-stateIncarceratedLaw violationsDisable/hospitalizedSelf-employedApprenticeshipUnknownCommentsEmailMessageSubmit
