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Site Supervisor's Evaluation Form
* Security Code
 
* Student Name
 
* Internship Site
 
* Semester/Year
 
* Evaluation Period
  Midterm Evaluation
Final Evaluation
 

Please evaluate the student using the scale below. Factors to consider include job duties, corporate intern benchmarks, assignments and expectations, and comparison with other student interns. Please note your comments and examples.

0 - not applicable 1 - unsatisfactory 2 - improvement needed
3 - satisfactory 4 - above average 5 - excellent

Please note your comments and examples.
 
* Ability to Learn
  • Asks pertinent and purposeful questions
  • Seeks out and utilizes appropriate resources
  • Accepts responsibility for mistakes and learns from experiences
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Reading/Writing/Computation Skills
  • Reads/comprehends/follows written materials
  • Communicates ideas and concepts clearly in writing
  • Works with mathematical procedures appropriate to the job
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Listening & Oral Communication Skills
  • Listens to others in an active and attentive manner
  • Effectively participates in meetings or group settings
  • Demonstrates effective verbal communication skills
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Creative Thinking & Problem Solving Skills
  • Breaks down complex tasks/problems into manageable pieces
  • Brainstorms/develops options and ideas
  • Demonstrates an analytical capacity
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Professional & Career Development Skills
  • Exhibits self-motivated approach to work
  • Demonstrates ability to set appropriate priorities/goals
  • Exhibits professional behavior and attitude
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Interpersonal & Teamwork Skills
  • Manages and resolves conflict in an effective manner
  • Supports and contributes to a team atmosphere
  • Demonstrates assertive but appropriate behavior
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Organizational Effectiveness Skills
  • Seeks to understand and support the organization’s mission/goals
  • Fits in with the norms and expectations of the organization
  • Works within appropriate authority and decision-making channel
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Basic Work Habits
  • Reports to work as scheduled and on-time
  • Exhibits a positive and constructive attitude
  • Dress and appearance are appropriate for this organization
  0     1     2     3     4     5    
* Comments & Examples
 

 
* Character Attributes
  • Brings a sense of values and integrity to the job
  • Behaves in an ethical manner
  • Respects the diversity of co-workers
  0     1     2     3     4     5    
* Comments & Examples
 

 

Open Category: Industry Specific Skills

Are there any skills or competencies that you feel are important to the profession or career-field (represented by your organization) that have not been previously listed in this evaluation? If so, please list these skills below and assess the intern accordingly.
 
Skill
 
Evaluation
  0     1     2     3     4     5    
Comments & Examples
 

 
Skill
 
Evaluation
  0     1     2     3     4     5    
Comments & Examples
 

 
Skill
 
Evaluation
  0     1     2     3     4     5    

 
* Would you employ this student in a position related to the internship
  Yes
No
* Comments
 

 
General Comments
 
* Overall Performance (if I were to rate the intern at the present time)
  1     2     3     4     5    

 
* This assessment was reviewed with the intern on (Month/Day/Year)
 
* Evaluator's Name
 
* Evaluator's Title
 
* Evaluator's Telephone Number
 
* Evaluator's Email Address
 
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