Vocational Mentorship Program Questionnaire

The New Beginnings Club and Brain Injury Association of Chatham-Kent is currently researching the development of a "Vocational Mentorship Program". The intent of this program is to facilitate the development of skills, experience, and confidence of member/survivors of the New Beginnings Club, by helping them address employment concerns. The program would facilitate the placement of a member in a suitable workplace setting, agreed upon by the member and an employer, on a volunteer basis for a period of approximately three months. Together, the employer and the co-workers would mentor the volunteer in the development of skills in a friendly environment. The member would then be able to take this experience and confidently apply it to future employment pursuits.

Please take a few moments to fill out this survey. The information obtained in this questionnaire will be used to direct the development of the program and, if indicated at the end of the survey, will be used to assist and direct specific members in determining the areas in which they excel and their level of interest in returning to the work force.

The information collected in this survey will in no way be used in any assessment that may be required of you by your insurance, medical, or therapeutic coverage. This survey does not measure your physical or mental capabilities, nor does it serve any diagnostic purposes. The answers will remain completely anonymous, unless you choose to include your name and contact information. Please answer the questions as honestly as you can. The survey is designed to allow you to enter as much information as you need to answer the questions.

Thank you for your time and assistance!

Please click Submit at the bottom of the page to send your response. To clear the form, click Reset at the bottom of the page.