Fillable ExerciseScienceHandbookAppG1 APPENDIX E

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ExerciseScienceHandbookAppG1 APPENDIX E

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APPENDIX G-1
INTERN EVALUATION FORM
MID-TERM
Name (Student Name) Agency Name____________________________________________
Date: __________
Instructions:
This form is to be completed by the site supervisor of the organization hosting the field experience student. Please evaluate the performance of the student by circling the number
you feel best expresses your perceptions of the student’s performance. As you proceed through the evaluation, you are encouraged to write comments on each statement so the
student can better understand your evaluation. The student will also provide a self-addressed envelope to mail the completed form.
PERFORMANCE AREA
LESS THAN ADEQUATE
ADEQUATE
MORE THAN ADEQUATE
EXCELLENT
ABILITY TO ORGANIZE AND
CARRY OUT TASK
1 2 3
Has some difficulty organizing and
carrying out assigned tasks.
4 5 6
Manages to organize and
carry out most assigned
task in a competent
manner.
7 8
Very well organized and carries out
assigned tasks in a professional manner.
9 10
Exceptionally well organized. Carries
out assigned tasks in an exemplary
manner
Comments:
QUALITY OF ASSIGNED
WORK
1 2 3
Below expectations. Needs
frequent instruction and
supervision. Work completed is
less than satisfactory.
4 5 6
Meets expectations. Needs
some supervision. Quality
of work is competent.
7 8
Usually exceeds expectations. Needs very
limited supervision. Work is of very good
quality.
9 10
Consistently exceeds expectations.
Work is always of highest quality.
Comments:
TIME MANAGEMENT
1 2 3
Procrastinates much of the time.
Does not complete most tasks in a
timely manner.
4 5 6
Average ability to manage
time. Some
procrastination, but most
task completed on time.
7 8
Very efficient in managing time. All
tasks are completed on schedule.
9 10
Exceptional ability to manage time on
tasks. Most work is completed ahead of
schedule.
Print Form
Submit by Email
Comments:
PERFORMANCE AREA
LESS THAN ADEQUATE
ADEQUATE
MORE THAN ADEQUATE
EXCELLENT
ABILITY TO COMMUNICATE
ORALLY
1 2 3
Has difficulty conveying
information/ideas to individuals and
groups. Does not seem to be
comfortable with oral
communication.
4 5 6
Can competently express
information/ideas to
individuals and groups.
Reasonably comfortable in
most situations.
7 8
Very effective in conveying
information/ideas to individuals and
groups. Comfortable during oral
communications.
9 10
Exceptional ability to communicate
information/ideas effectively to
individuals and groups. Very
comfortable and confident during
oral communication.
Comments:
ABILITY TO COMMUNICATE
IN WRITTEN FORMAT
1 2 3
Below expectations. Has difficulty
conveying information/ideas in
writing. Numerous errors.
4 5 6
Can satisfactorily convey
information/ideas in
writing. Usually free of
errors.
7 8
Very effective in conveying
information/ideas in writing. Errors are
rare.
9 10
Exceptional ability to
communicate information/
ideas in writing. Work is
creative.
Comments:
DEPENDABILITY &
RESPONSIBILITY
Comments
1 2 3
Sometimes fails to complete work.
Requires a great deal of supervision
in order to produce work.
4 5 6
Can be counted on to have
task completed when
required. Sometimes
needs some supervision to
do so.
7 8
Can always be counted on to have task
completed. Is conscientious in
performance of all assigned duties.
9 10
Exceptionally dependable and
responsible in all circumstances.
PERFORMANCE AREA
LESS THAN ADEQUATE
ADEQUATE
MORE THAN ADEQUATE
EXCELLENT
INITIATIVE & ENTHUSIASM
:
1 2 3
Must be pushed to get projects
started and completed. Does not
display enthusiasm for assigned
work.
4 5 6
Usually enthusiastic about
assigned work. Sometimes
waits for assignments and
projects rather than taking
initiative.
7 8
Self-starter. Makes the most of
opportunities. Enthusiastic and requests
additional responsibilities.
9 10
Consistently exceeds expectations
in this area. Regularly requests
opportunities to explore new
assignments and projects. Makes
the most of every opportunity.
Comments
ABILITY TO WORK WITH
OTHERS IN THE ORGANIZATION
1 2 3
Usually gets along with people in
the organization. Rarely initiates
contact with other people and could
be more outgoing.
4 5 6
Gets along with people in
the organization. Usually
initiates contact with other
personnel. Usually
outgoing.
7 8
Very good relationship with personnel at
all levels of contact. Interaction is
positive and productive.
9 10
Exceptionally good relationships
with personnel at all levels.
Interaction is positive, productive
and sensitive to the needs of others.
Comments:
PROFESSIONAL APPEARANCE
AND BEHAVIOR
1 2 3
Needs to be reminded frequently
about appropriate attire and
behavior in the work setting.
4 5 6
Seldom needs to be
reminded of appropriate
attire and behavior in the
work setting.
7 8
Appearance and behavior is always
appropriate to the work setting.
9 10
Appearance and behavior is
exceptional and worthy of
emulation by others.
Comments:
PERFORMANCE
LESS THAN ADEQUATE
ADEQUATE
MORE THAN ADEQUATE
EXCELLENT
ABILITY TO ACCEPT AND
UTILIZE SUGGESTIONS TO
IMPROVE PERFORMANCE
Comments:
PLEASE ADD ANY
ADDITIONAL COMMENTS
THAT YOU FEEL WOULD BE
INSTRUCTIVE TO THE
UNIVERSITY SUPERVISOR
IN EVALUATING AND
PROVIDING GUIDANCE TO
THIS INTERN
1 2 3
Almost always rejects or discounts
suggestions to improve
performance. Rarely, if ever,
attempts to utilize suggestions.
4 5 6
Usually accepts
suggestions to improve
performance. Usually
successful in utilizing
suggestions.
Evaluator Signature
7 8
Always welcomes suggestions to improve
performance. Makes a concerted effort to
utilize suggestions.
__________________________________
9 10
Always welcomes and solicits
suggestions to improve performance.
Exceptionally successful in this
endeavor.
I hereby certify that the information I am submitting is complete and accurate. I understand that checking “I Agree” below acts as my signature on this form.
I Agree Date_____________________ (mm/dd/yyyy)
Name_____________________________________
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ExerciseScienceHandbookAppG1 APPENDIX E

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Completed 8 February 2020

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