Johnson State College Internship Program
SITE SUPERVISOR EVALUATION OF JSC INTERN
Thank you for hosting a Johnson State College intern. This opportunity allows students to test their academic knowledge in community based organizations and to work
with professional mentors within your sta.
Instructions:
The evaluative process is extremely important and is a critical part of the internship process. This form is used for four primary purposes:
• Toprovidethestudentwithevaluativefeedbackconcerningperformanceofhisorhermajorareasofresponsibilityinthisassignment;
• Toidentifyareasinwhichthestudentneedstostriveforimprovement;
• Togivethestudentanideaofhisorhercurrentstrengthsandweaknessesasrelatedtothepursuitofacareer;
• Tohelpthefacultysupervisordetermineasatisfactory/unsatisfactorygradeforthestudent’sperformance.
Notonlydoesthisevaluationgivethestudentthechancetoreectupontheinternshipexperience,butitalsogivesyou,thesitesupervisor,theopportunity
tohelpimprovetheexperienceforfutureinternsandthesitesupervisorswhohostthem.Therefore,boththestudentandthesitesupervisorarerequested
tocompletethesameevaluationform.Thesupervisorandthestudentshouldcompletetheseevaluationsindependentlyandthendiscussthemjointlyin
anevaluationconference.Knowingitisdiculttoremainobjectivewithevaluationforms,pleaseexerciseyourbestpersonalandprofessionaljudgmentin
completingthisevaluation.Please complete this form and return to the Johnson State College faculty supervisor by the date specied on the internship
contract.
Note:Shouldthesitesupervisorhaveanagencyevaluationformavailableandprefertousethatform,itmaybesubstitutedforthisform.
Check one: Mid-term End-of-term
Date:
Intern Name:
Term: Fall Spring Summer Year:
Internship Site:
SiteSupervisorsName:
SiteSupervisorsEmail:
JSC Faculty Supervisor Name:
JSCFacultySupervisorEmail:
Section A.
Site Supervisor Evaluation of Intern: Pleasemakeajudgmentforeacharealistedbelow.Descriptivephrasesandwordshavebeenincludedtoprovideaclearer
understandingofeacharea.Usethefollowingratingscale:
(1) Poor (2) Fair (3) Adequate (4) More than Adequate (5) Excellent (6) N/A
Individual Characteristics:
Personal Appearance:
Appropriatelydressed;well-groomed.
Dependability:
Reliable;punctual;completesassignmentson
orbeforeduedate.
Initiative:
Abletothinkandworkindependently;looksfor
andndsmeaningfulwork;self-starter.
Personality:
Enthusiastic,courteousandtactful;friendly;
displaysaconcernforothers;displaysasense
of humor.
Ability to Accept Feedback:
Iswillingtoacceptsuggestions,direction
andcriticalevaluation;iscriticalofown
performanceandqualityofwork;worksto
improveperformancefollowingsuggestions.
Comments:
Professional Characteristics:
Knowledge of Position:
Displaysanoperationalknowledgeoftheskills
anddutiesrequiredtoperforminthisposition,
commensuratewitheducationallevel;
examplesincludeknowledgeofphilosophy,
administrativepractices,andprogramming
methodsandmaterials;canapplythese
principlestojobperformance.
Leadership:
Conductsselfwellbeforegroups;displays
exibilityandabilitytomakedecisions;displays
maturejudgment.
Creativity:
Displaysimagination;usesphysicalandhuman
resourceswell;generatesandimplementsnew
ideas.
Judgment:
Possessescommonsense;prioritizestasks;
evaluatesbeforemakingadecision;usestact.
Commitment:
Displaysazealfortheprofession;accepts
assignmentswillingly;isactiveinprofessional
organizations.
Relationships:
Relateswelltootheremployees;relateswell
withpublic(clients)and/orotheragencies.
Comments:
Overall Intership Evaluation:
Qualityoftotalperformanceonthebasis
ofjobrequirements,assignmentsand
objectives.
Comments:
RatingRating
Rating
IfyouwererequiredtoassignaPass/Failgradefor
yourselfinrespecttothisinternshipexperience,it
wouldbe:(checkone)
PASS FAIL
SupervisorsSignature:
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