Fillable Self-assessment-form Employer’s Intern Evaluation Form

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Self-assessment-form Employer’s Intern Evaluation Form

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Instructions: Please provide honest feedback concerning your strengths and weaknesses. Your answers
Will not impact your grade in this course but will provide an opportunity for you to look at all aspects of
your performance on the job. This form will be kept confidential between you, the Internship office, and
your department. Please complete both pages of this evaluation and submit by fax 660-543-4578 or by
dropping it by Grinstead 009G.
Reliability Always Reliable Punctual Often Tardy Often Absent
(Place an X next to the choice that best applies)
Intern’s Self-Assessment Form
University of Central Missouri
SOT 3022 and 5022
Technology Internship
Intern name:
Company name:
Company location:
Supervisor name:
Ability to Learn
exceptionally sharp
learns work quickly
typical learner
rather slow in learning
needs excessive repetition
Attitude
enthusiastic & positive
interested, industrious
average diligence, interest
somewhat aloof
definitely not interested
Dependability
entirely dependable
strong sense of responsibility
frequently dependable
sometimes neglectful
careless, unreliable
Leadership
exceptional leader
strong leader
frequently leads or delegates
occasionally leads or delegate
unable to lead or delegate
no basis for judgment
Initiative
creates opportunities
generally a self-starter
works independently at times
rather hesitant
needs lots of direction
Judgment
exceptionally mature judgment
good common sense
usually makes good choices
frequently makes poor choices
bad judgment
Maturity
exceptionally mature
above average maturity
average maturity
somewhat immature
terribly immature
Problem Solving
exceptional problem solver
good problem solver
solves problems with guidance
solutions lack basis
difficulty in finding solutions
no basis for judgment
Relations with co-workers
extremely well respected
works well with others
gets along satisfactorily
difficult to work with some
often disagreeable
Quality of Work
committed to perfection
detail-minded
average quality
content with minor errors
satisfied with poor quality
Quantity of Work
exceptionally high output
more than average output
normal amount
below average
poor output, slow
Planning
exceptional foresight
plans well for most situations
occasionally plans well
plans are usually unattainable
crisis manager-lacks planning
no basis for judgment
Please rate yourself by placing an “X” next to the most appropriate response for each category.
Intern Evaluation Pg. 2
Return to: Intern’s Name: __________________
University of Central Missouri
Technology Internship Office, G009-G
Warrensburg, MO 64093
Attn: Internship Office
FAX: 660-543-4578
techinterns@ucmo.edu
REMARKS
My outstanding personal qualities are:
The personal qualities which I should strive most to improve are:
Suggestions for other course work which could have been helpful in enabling me to more adequately meet
the needs of my job:
Additional remarks:
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Self-assessment-form Employers Intern Evaluation Form

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Completed 16 November 2019

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