Student’s Name _______________________________ Major ___________________
 
Student’s Supervisor ___________________________ Location ________________
 
Review Date _______________________________
 
Instructions:  The immediate supervisor should evaluate the student objectively, comparing him/her with other students of comparable academic level, with other personnel assigned the same or similar positions, or with individual standards.  Remarks are particularly helpful appreciated. 
 
Attitude – Application to Work Ability to Learn
 

( ) Enthusiastic  ( ) Very interested and industrious  ( ) Average in diligence and interest  ( ) Somewhat indifferent  ( ) Definitely not interested

( ) Learned tasks very well ( ) Learned work readily  ( ) Average in understanding work  ( ) Rather slow in learning ( ) Very slow to learn

Initiative Quality of Work

( ) Proceeds well on his/her own  ( ) Frequently works well on own  ( ) Does all assigned work   ( ) Hesitates  ( ) Must be pushed frequently

( ) Excellent  ( ) Very Good ( ) Average  ( ) Below average ( ) Very poor

  
Dependability Relations with others 

( ) Completely dependable  ( ) Above average in dependability  ( ) Usually dependable  ( ) Sometimes neglectful  ( ) Unreliable

( ) Exceptionally well accepted ( ) Works well with others   ( ) Gets along satisfactorily ( ) Difficulty working with others ( ) Works very poorly with others

  
What do you consider the student’s most significant strengths?

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What areas of improvement would you suggest for this student?

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If your organization had an opening for a person with the background of this student, would you hire her/him?  Why?

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Do you have suggestions that would improve the Internship/Practicum Program?

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Would you be interested in having another student for a future semester?  If yes, please briefly describe the student’s proposed responsibilities.

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Intern/Practicum Supervisor’s Signature ______________________________________________ Date ____________________