Mentor Candidate

Court Services and Offender Supervision Agency
for the District of Columbia

Faith-Based Re-Entry Initiative
Mentor Candidate Questionnaire Part II

Name:

6. Health and Leisure:

* Do you have any training in health care or nutrition? Yes No

* Would you say you are knowledgeable about health and fitness? Yes No

* How do you maintain good health?

* Do you exercise regularly? How?

* Could an offender have any health concerns that would be troublesome to you? Yes No

* If so, what would be the issue?

* Do you have any hobbies or sports interests? Yes No

* How much time do you devote to them?

* What would you say are your unique talents?

* What do you like to do most in your leisure time?

7. Motivational Skills:

* Have you ever worked as a teacher or trainer? Yes No

* Would you say you are good at it? Yes No

* Do you think you are good at explaining things to others? Yes No

* How would you describe your ability to motivate others?

* Tell me about a leadership experience you have had.

8. Skills, Abilities and Interest:

Please rate your ability to:	1 I would feel comfortable doing this	2 I might do this if I had more training or information	3 I would not feel comfortable doing this
Help the mentee with a school assignment.	1	2	3

Be present during a difficult conversation between the mentee and a family member	1	2	3

Take the mentee to a job interview	1	2	3

Take the mentee to open a bank account	1	2	3

Help the mentee with a resume or job application	1	2	3

Help the mentee identify training opportunities in his/her area of interest	1	2	3

Help the mentee plan a week's menu and shop for food	1	2	3

Help the mentee develop a daily schedule	1	2	3

Teach the mentee some basic cooking skills	1	2	3

Call the mentee every evening for a few minutes to see whether s/he is keeping to the schedule we worked out.	1	2	3

Help the mentee develop a budget	1	2	3

Help the mentee find temporary shelter	1	2	3

Join a leisure activity (bowling league, basketball team book group) with the mentee	1	2	3

Discuss family problems with the mentee	1	2	3

Discuss the mentee with family members/friends, who are concerned about him/her	1	2	3

Talk to the mentee every day about whether s/he experienced any of his/her triggers that might lead to drug use	1	2	3

	Security Code: >>>>> Daniel Payne
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