Fillable College Teaching Internship Forms (Saint Louis University)

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College Teaching Internship Forms (Saint Louis University)

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Student Name: _____________________________________
College/University: __________________________________
College Course: ____________________________________
Teaching Mentor: ___________________________________
Please identify two learning objectives from each category below:
ACADEMIC OBJECTIVES:
1.
2.
PERSONAL OBJECTIVES:
1.
2.
FUTURE TEACHING/CAREER-RELATED OJECTIVES:
1.
2.
SAINT LOUIS UNIVERSITY
HIGHER EDUCATION ADMINISTRATION
College Teaching Internship
LEARNING OBJECTIVES
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 1 of 12
Internship Handbook
TEACHING SITE STUDENT
College/University: ___________________________ Student Intern: _____________________
Teaching Mentor: __________________________ Student Address: ___________________
Mentor’s Title: ________________________ ____________________________________
Department Address: ________________________ Student Phone: ____________________
___________________________________________ ___ Student Email: _____________________
Mentor’s Phone: __________________________ Faculty Advisor: ____________________
Mentor’s Email: ___________________________ Advisor’s Phone: ___________________
A. CONDITIONS OF INTERNSHIP
1. The internship will be _______ weeks in duration with an average of _______
hours per week.
2. The internship will begin on _________________ (day/month/year) and will
end on or about ________________ (day/month/year).
3. The student will intern at the site on the following days and times (please
note your schedule):
______________________________________________________________________
4. The student intern and site supervisor will decide on work assignments and
projects that meet the following student’s learning objectives: (Decide on three
main learning objectives from the Learning Objectives Form)
A._____________________________________________________________________
B. _____________________________________________________________________
C. _____________________________________________________________________
B. RESPONSIBILITIES OF STUDENT INTERN
1. The student intern is to be present at the teaching site on the days and
times specified above.
SAINT LOUIS UNIVERSITY
HIGHER EDUCATION ADMINISTRATION
College Teaching
INTERNSHIP AGREEMENT FORM
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 2 of 12
Internship Handbook
2. The student intern is expected to comply with the teaching expectations
of the college/university for which their teaching internship will take place.
3. If the student intern is ill or for other reasons cannot be present at the site,
he or she should inform the site supervisor of the absence as soon as
possible.
4. The student intern is expected to behave and dress professionally.
5. The student intern is expected to complete work assignments and projects
in a professional and timely fashion.
C. RESPONSIBILITIES OF THE SITE SUPERVISOR
1. The teaching mentor should provide adequate training or informal
assistance when necessary.
2. The teaching mentor should provide adequate feedback on the student
intern’s performance.
3. The site supervisor is should help the student intern gain professional skills
and knowledge.
The Student Intern and Teaching Mentor agree to the above conditions and
responsibilities of the Internship.
Signature of Student Intern: ______________________________________
Date: _________
Signature of Teaching Mentor: ______________________________________
Date: _________
Return form to: Dr. Karen Myers
Saint Louis University
3500 Lindell Boulevard
Fitzgerald Hall
St. Louis, MO 63108
(314) 977-3214
Office use only:
Reviewed: / /
click to sign
signature
click to edit
click to sign
signature
click to edit
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 3 of 12
Internship Handbook
Student Name: _______________________ Dates of Internship: _________________
Student Phone: _______________________ College/University: _________________
Student Email: _______________________ Course: ____________________
Teaching Mentor: __________________
Please take a few minutes to evaluate your performance at the internship site.
Please evaluate yourself in comparison to other student interns/employees.
PART ONE: PERRFORMANCE REVIEW
Please rate your performance by checking the box that corresponds with your
assessment of your performance in the current internship.
Rating Scale:
Excellent =5 Performance significantly above proficiency level
Above Average = 4
Performance above proficiency level
Average = 3 Proficient performance
Improvement Needed = 2 Performance below proficiency level
Unsatisfactory = 1 Performance requires considerable impr
ovement
Not Applicable =NA Not applicable in this internship experience
WORK RELATED PERFORMANCE
5 4 3 2 1 NA
1. Work attitude (ex. Initiative, enthusiasm)
2. Academic preparation
3. Problem-solving ability
4. Classroom Management
5. Adaptability
6. Progress towards learning goals
SAINT LOUIS UNIVERSITY
HIGHER EDUCATION ADMINISTRATION
College Teaching
STUDENT INTERN SELF-EVALUATION
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 4 of 12
Internship Handbook
ORGANIZATIONAL SKILLS
5 4 3 2 1 NA
7. Time management skills
RELATIONSHIPS WITH OTHERS
9. Availability to students in course
10. Ability to work with teaching mentor
11. Acceptance of
constructive comments
12. Ability to take direction
COMMUNICATIONS SKILLS
13. Oral communication skills
14. Written communication skills
15. Listening skills
OVERALL RATING
PART TWO: ACCOMPLISHMENTS
Please provide the following information about your internship experience. If
additional space is needed, please attach an additional page to this evaluation.
1) Identify the most important learning or personal objective you had set for
yourself when beginning the college teaching internship.
2) How well do you feel you accomplished these goals in this internship?
3) Explain your process for lesson planning and how this internship may have
improved those skills?
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 5 of 12
Internship Handbook
4) Identify any obstacles that were encountered during classroom time and
describe how you managed them.
5) Describe any noteworthy accomplishments you achieved during this college
teaching internship.
Student Signature:_______________________________________
Date:____/____/_____
Return form to: Dr. Karen Myers
Saint Louis University
3500 Lindell Boulevard
Fitzgerald Hall
St. Louis, MO 63108
(314) 977-3214
Office use only:
Reviewed: / /
click to sign
signature
click to edit
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 6 of 12
Internship Handbook
Student Name: _______________________ Dates of Internship: _________________
Student Phone: _______________________ College/university: _________________
Student Email: _______________________ Teaching Mentor __________________
Course:____________________________
Please take a few minutes to evaluate your internship experience. This
evaluation will not be shared with your site supervisor. The purpose of this
evaluation is to assist in the coordination of future Higher Education
Administration internships. If additional space is needed, please attach an
additional page to this evaluation
1) How would you rate this college teaching internship experience in
terms of helping you gain professional skills and knowledge?
Excellent Very Good Good Requires
Improvement
2) How well did the teaching internship experience align with your
learning goals?
SAINT LOUIS UNIVERSITY
HIGHER EDUCATION ADMINISTRATION
College Teaching
STUDENT EVALUATION OF INTERNSHIP
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 7 of 12
Internship Handbook
3) Did your teaching mentor provide adequate training or informal
assistance?
4) Did your teaching mentor provide adequate feedback on your
performance?
5) List any positive aspects of interning at this site.
6) List any negative aspects of interning at this site.
7) Would you recommend this college teaching site to another student?
Yes No
-Why or why not?
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 8 of 12
Internship Handbook
8) Overall, my internship experience was:
Extremely Valuable Very Valuable Valuable
Not Very Valuable Of No Value
Student Signature:_________________________________
Date:____/____/_____
Please Return form to:
Dr. Karen Myers
Saint Louis University
3500 Lindell Boulevard
Fitzgerald Hall
St. Louis, MO 63108
(314) 977-3214
Office use only:
Reviewed: _____/____/_____
click to sign
signature
click to edit
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 9 of 12
Internship Handbook
Student Name: _______________________ Dates of Internship: _________________
Student Phone: _______________________ College/university: _________________
Student Email: _______________________ Teaching Mentor __________________
Course:____________________________
Please take a few minutes to evaluate the student intern’s performance. Once
completed, please review your assessment with the student intern. . The intern
should be evaluated in comparison to other student interns/teaching assistants.
PART ONE: PERRFORMANCE REVIEW
Please rate the student intern’s performance by checking the box that
corresponds with your assessment of the student intern’s performance.
Rating Scale:
Excellent =5 Performance significantly above proficiency level
Above Average = 4 Performance above proficiency level
Average = 3 Proficient performance
Improvement Needed = 2 Performance below proficiency level
Unsatisfactory = 1 Per
formance requires considerable improvement
Not Applicable =NA Not applicable in this internship experience
WORK RELATED PERFORMANCE
5 4 3 2 1 NA
1. Work attitude (ex. Initiative, enthusiasm)
2. Academic preparation
3. Problem-solving ability
4. Class Management
5. Adaptability
6. Progress towards learning goals
SAINT LOUIS UNIVERSITY
HIGHER EDUCATION ADMINISTRATION
Teaching Mentor EVALUATION OF
College Teaching PERFORMANCE
Version 1.0 Higher Education Administration Page 10 of 12
Internship Handbook
ORGANIZATIONAL SKILLS
5 4 3 2 1 NA
7. Time management skills
8. Lesson Planning organization
RELATIONSHIPS WITH OTHERS
9. Availability to students in course
10. Ability to work with teaching mentor
11. Acceptance of
constructive comments
12. Ability to take direction
COMMUNICATIONS SKILLS
13. Oral communication skills
14. Written communication skills
15. Listening skills
OVERALL RATING
PART TWO: ACCOMPLISHMENTS
Please describe any noteworthy teaching experiences or accomplishments the
student intern has completed during the internship. (If additional space is needed,
please attach additional page to evaluation.)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Version 1.0 Higher Education Administration Page 11 of 12
Internship Handbook
OVERALL EVALUATION
Please describe your overall evaluation of the student intern. (If additional space
is needed, please attach additional page to evaluation.)
Teaching Mentor’s Signature:___________________________
Date:____/____/____
Please return form to: Dr. Karen Myers Saint Louis University
3500 Lindell Boulevard
Fitzgerald Hall
St. Louis, MO 63108
(314) 977-3214
Office use only:
Reviewed: _____/____/_____
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Completed 23 July 2020

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