MIDTERM 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:
Number of hours intern has completed thus far:
  
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

 

 

Midterm Progress Report :    

1. Please provide comments on the student's progress in meeting objectives of the internship. For shadowing experiences, please comment on the student's observational experiences.

2.Would you like to be contacted at this time by the internship coordinator?

YES NO

 

You may print and review the completed midterm evaluation after submission.

 

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