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Deadline to register for the spring season extended to December 20th
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Duke City Mentor Form
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Mentor Name
*
Mentor Email
*
Mentee Name
*
Mentee Email
*
Mentee Profile
Date / Time of Match
Date
Time
Field Location of Match
PLEASE SELECT
SC 1 S
SC 1 N
SC 2 S
SC 2 N
SC 3 S
SC 3 N
SC 4
SC 5
SC 6 N
SC 6 S
SC 7
SC 8
SC 9
SC 10
SC 11
SC 12
SC 13 N
SC 13 S
SC 14 N
SC 14 S
SC 15
SC 16
SC 17
SC 18
SC 19
SC 21 N
SC 21 S
SC 22
Position of Mentee
CR
AR 1
AR 2
AR 3
AR 4
AR 5
AR 6
The person who was mentored was in this position (OLD)
CR
AR 1
AR 2
AR 3
AR 4
AR 5
AR 6
Positioning along touchline during active play and staying at the offside line
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Position at corner for signaling GK or CK
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Positioning/Movement
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Positioning/Movement Comments
Accuracy when signaling offside:
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
4 = Offsides did not occur
Correct mechanics when signaling for offside
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
4 = Offsides did not occur
Comment on offside signaling
Accuracy when signaling throw-ins
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Correct mechanics when signaling throw-ins
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Comment on throw-in signaling
Proper hand for carrying the flag when not signaling:
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Accuracy and mechanics when signaling GK and CK
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Accuracy and mechanics when signaling fouls in AR’s area:
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
4-Foul in Area Did Not Occur
Positioning for a Penalty Kick
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
4-PK Did Not Occur
Made eye contact with Referee/AR when needed:
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Decision Making/Rules Application
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Decision Making/Rules Application: Comments
Interaction with Team
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Interaction with Team Comments
Signaling:
Please Select
1 = Good
2 = Satisfactory
3 = Needs Improvement
Signaling Coments
Did the referee have the proper jersey and badge and was the jersey tucked in an worn approriatley
Yes
No
Did the referee wear black shorts
Yes
No
Did the referee wear black socks that were pulled up just below the knee
Yes
No
Uniform/Appearance comments
Comments for the Assignor (will not get sent to mentee)
Comments for the Mentee
Mentor's Recommendation
Please Select
Mentee is Good to AR games
Mentee is Good to Center Games
Mentee needs to another AR mentor game
Mentee needs another CR mentor game
Do you want this form sent to the mentee?
Yes
No
Is this form completed
Yes
No
Send Mentor and Mentee the assignment
yes
no (click here if you are a mentor)
How many games was the mentee mentored
Assignor Access Only
Click if you are an assignor
Assignor's Password
Entered Into Ref Base
Yes
No
Assignor's Action
Needs another AR game
Needs another CR game
Another AR game helpful
Another CR game helpful
Can AR
Can CR
Submit
