MENTORING QUESTIONAIRE Print and complete form and mail to:
Patti Ashley 2625 fm 1704, Elgin, Tx 78621

These questions are designed to help match up people geographically as well as protect your time and schedule. Thank you for your interest in the mentoring program.

NAME_______________________________________________________

Address______________________________________________________

One Day Campus you attend______________________________________

1. In what part of the Austin area do you live?_______________________________

2. What is the best number to call?_______________________________

3. Do you prefer e-mail contact and if so, give your e-mail address below – please print.

4. How many years have you home taught?________________________________

5. What are the ages of your children?

____________________________________________________________________

6. What curriculum has been your favorite over the years and why.

7. Do you have an interest in meeting with the person needing assistance? _______

8. If so, how often would you be available?__________________________________

Your comments: