FINAL EVALUATION

INTERNSHIP/PRACTICUM/FIELD EXPERIENCE
Supervisor

ENTER PASSWORD PROVIDED BY THE KINESIOLOGY CAREER CENTER:

Please complete the information below:    
Experience start date:
Experience end date:
Total number of hours intern completed with you:
  
Intern Name:
 
(Last)
(First)  
 (Middle)
Supervisor Name:
 
(Last)
(First)  
 (Middle)
Supervisor Email:
Supervisor Title:
Agency Name:

 

Responsibilities of Intern:

 

Please rank the intern in the following areas (1 = below average and 5 = above average):

1.
 Accurate and Thorough
1
2
3
4
5
n/a
2.
 Able to Work Under Pressure
1
2
3
4
5
n/a
3.
 Effective Oral Communicator
1
2
3
4
5
n/a
4.
 Effective Written Communicator
1
2
3
4
5
n/a
5.
 Is Constructive and Mentally Alert
1
2
3
4
5
n/a
6.
 Applies Academic Training to Job
1
2
3
4
5
n/a
7.
 Has Positive Interpersonal Skills
1
2
3
4
5
n/a
8.
 Is Dependable
1
2
3
4
5
n/a
9.
 Exhibits Professional Attitude
1
2
3
4
5
n/a
10.
 Takes Initiative with Minimal Supervision
1
2
3
4
5
n/a
11.
 Uses Sound, Logical Judgment
1
2
3
4
5
n/a
12.
 Demonstrates Willingness to Accept Responsibility
1
2
3
4
5
n/a

 

 

General Assessment:    

1. Did the student meet the work objectives?

2.Please note outstanding characteristics or qualities of this intern.

3. Please list any areas in which this intern needs improvement.

4. Do you have any suggestions for our department with regard to internship placement, preparation of the intern, departmental correspondence/contact with your agency, etc?

 

You may print and review the completed evaluation after submission.

 

 
P. Setser
Comments: kines@indiana.edu
Copyright 2006, The Trustees of Indiana University