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Internship 2013 – Mentor Feedback Form
Internship 2013 – Mentor Feedback Form
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Mentor Details
Greeting
*
Dr.
Professor
Shri
Smt.
Ms.
First Name
*
Last Name
*
Designation
*
Institution [ Affiliation ]
*
IIT
IIM
Indian Foreign Service (IFS)
Indian Administrative Service (IAS)
Indian Police Service (IPS)
Indian Railway Service (IRS)
Indian Revenue Service (IRS)
Indian Forest Service (IFS)
Planning Commission
Rakshak Foundation
Sharda University
Preferred email address
*
Feedback and Suggestions
1. Total time you spent with intern (including emails, phone etc)
*
Less than 3 Hours
3 - 5 Hours
5 - 7 Hours
7 - 10 Hours
Over 10 Hours
2. Your overall rating of the intern's work [1 - Very Poor to 10 - Exceptional]
*
1
2
3
4
5
6
7
8
9
10
3. Would you be able to help your intern in publishing the research work in a journal, government committee, department or conference ?
*
Yes
May Be
The work is not publishable
Too busy to help
4. Your advice to further improve this program. Do you think any recommendation from the project is implementable? If so, do you intend to implement it and how soon?
5. Please suggest project(s) for which you would be willing to be a mentor in future
6. Your complete postal address where memento should be mailed
*
8. Would you like to be a mentor next year again ?
*
Definitely
Willing to consider
Would not be available
Brochure and Website Specific Information Requested
1. Your Passport Size Photo for brochure and website
This is how last year's mentor's photos were shown in the brochure
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2. Upload your bio-data (your profile), in case you do not have time to type it in
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3. Your Brief Bio that can be used in the brochure and website
4. Your comments about mentorship experience and about this program
5. Your permission to include your information and comments in the brochure and website
*
Yes, both photo and comments
Only Photo
Only Comments
Only Name and Affiliation
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