Please fill out the following form for each of your co-op/intern students.  Complete the form and discuss with your student.  Please submit the form to our office before the last regular class day of the semester.

Thanks for all your help!!

This form should be completed by the student's immediate supervisor and discussed with the student.  CO-OPS AND INTERNSHIPS ARE LEARNING EXPERIENCES, PLEASE USE THIS FORM AS A TEACHING INSTRUMENT.  THANK YOU FOR TAKING THE TIME TO COMPLETE THIS COMPREHENSIVE REPORT.

Student's Name:

Major:

Current Work Semester and Year:

Employer:

Job Location:

Supervisor's Name:

Supervisor's Title:

Supervisor's Phone Number:

Supervisor's E-mail address:
 

Briefly describe the student's work assignment for this term:
  
 
 
 
  Student's overall attitude toward work assignments.
 
Enthusiastic        Indifferent

Eager to learn    Bored

Receptive            Disinterested

Diligent               Unenergetic
 
 

Effectiveness in executing assignments. Productive?  Learns quickly?  Self-starter?  Shows initiative in solving problems?  Fails to understand and/or follow directions?  Meets deadlines?  Requires close supervision?  Applies self consistently to work?  Needs to ask more questions?
 

Dependability.  Responsible?  Judgement generally appropriate for the situation?  Hesitant to make decisions?  Careless in meeting obligations?  Follows through consistently on assignment?  Gives way to minor obstacles or inconveniences?  Persistent?
 
 
Relations with others.  Considerate?  Friendly?  Distant?  Fits smoothly into working team?  Shy?  Open?  Secretive?  Cooperative?  Respected?  Brash?  Receives suggestions well?  Makes others uncomfortable?  Tactful?  Argumentive?  Honest?  Mature?  Objective?
 
 
Work ethic.  Prompt?  Tardy?  Wasteful?  Professional attitude?  Appropriate in dress and grooming?  Makes excuses?  Poised?  Accepts praise and criticism appropriately?
 
 
What kind of feedback have you provided this student about his/her performance during this work period?  In what way has progress been reviewed, and how often?
 
 
How has this student responded to your suggestions for carrying out his/her work assignment?
 
 
If this is the final work period for this student, please comment on the adequacy of his/her academic preparation.
 
 
What is your overall evaluation of this student for his/her current level of work experience and education?  (circle one)
 
   Excellent      Above Average      Average      Poor

Has the general content of this report been discussed with this student?

  Yes     No