Programs

EMAP Check-in Form 2023-2024

Welcome, EMAP participants! Please complete this form honestly and within the given time period.

Submission offer EMAP staff clarity on how relationships are developing and they will provide support in whichever areas help is needed.

For questions and comments, email emap-ome [at] mit.edu (emap-ome[at]mit[dot]edu).

Your First Name

Your Last Name

I am a...

Mentor

Protégé

Your Mentor or Protege's First Name

Your Mentor or Protege's Last Name

How would you rate the relationship with your mentor/protégé currently?

Great/Awesome

Going Well/Continuing to Develop

Needs Improvement/Not Going Well

How quickly does your mentor/protégé respond to your outreach?

Same day

1-2 days

3-5 days

Longer than 5 days

How many meetings/connections did you have with your mentor/protégé since last check-in?

	What methods are you using to meet/connect? (Check all that apply)
Email	Email
Phone Call	Phone Call
Text Message	Text Message
Video Call (Zoom, Skype, FaceTime, Teams, etc.)	Video Call (Zoom, Skype, FaceTime, Teams, etc.)
In-person meeting	In-person meeting
Other	Other

If "other," please enter the platform used to communicate:

Please summarize what you and your mentor/protégé have been working on:

Is your next meeting scheduled?

Yes

Do you have any additional comments or concerns?

Your Email