EVALUATION OF CO-OP STUDENT’S WORK EXPERIENCE
Cooperative Education
Supervisors Evaluation Report
GENERAL INFORMATION
Site Name Date
Please complete this form, sign, date and mail to:
Robert A. Henderson, Director of Cooperative Education, Manchester Community College, Great Path, MS #8, P.O. Box 1046, Manchester, CT 06045-1046
Email: rhenderson@manchestercc.edu Phone: 860-512-3312 Fax: 860-512-3371
Supervisor’s Name Title
Student’s Name Student Title
June 2017/PR
www.manchestercc.edu/coop
Relations with Others
n
Exceptionally well accepted
n
Works well with others
n
Gets along satisfactorily
n
Has some difficulty working with others
n
Works very poorly with others
n
Unable to evaluate
Ability to Learn
n
Learns very quickly
n
Learns readily (works with minimal
supervision)
n
Average in learning
n
Rather slow to learn
n
Very slow to learn
n
Unable to evaluate
Negotiating Ability/Problem Solving
n
Excellent use of resources, ability to
reach consensus
n
Clearly identifies problems and
solutions
n
Listens and provides support
n
Unable to independently resolve conflict
n
Unable to evaluate
Attitude—Application to Work
n
Outstanding in enthusiasm
n
Very interested and industrious
n
Average diligence
n
Somewhat indifferent
n
Definitely not interested
n
Unable to evaluate
Quality of Work
n
Excellent
n
Very Good
n
Average
n
Below Average
n
Very poor
n
Unable to evaluate
Punctuality
n
Regular
n
Irregular
Attendance
n
Regular
n
Irregular
Judgment
n
Exceptionally mature
n
Above average in making decisions
n
Usually makes the right decision
n
Often uses poor judgment
n
Consistently uses poor judgment
n
Unable to evaluate
Serves Clients/Customers
n
Extremely attuned to needs of clients
n
Very supportive, enthusiastic
n
Satisfactory
n
Poor
n
Inconsistent; sometimes not attentive
to needs of client
n
Unable to evaluate
Performance
n
Outstanding performance; substantially exceeded expectations
n
Exceeded expectations and performance standards
n
Met all performance standards
n
Met some performance standards, but did not meet expectations
n
Performance substantially below normal expectations and standards
Dependability
n
Completely dependable
n
Above average dependability
n
Usually dependable
n
Sometimes neglectful or careless
n
Unreliable
n
Unable to evaluate
Works with Diversity
n
Excellent awareness and respect for
cultural differences
n
Recognition of standards other than
his/her own
n
Needs improvement
n
Demonstrates lack of willingness to
accept others different from self
n
Unable to evaluate
Please select only one in each category.
REQUIRED
EVALUATION OF CO-OP STUDENT’S WORK EXPERIENCE
Supervisor’s Signature and Title Date
June 2017/PR
www.manchestercc.edu/coop
Please indicate any particular strengths and/or weaknesses you feel this student possesses.
Please describe what you feel the student has learned during this experience, and what personal or professional growth he/she has demonstrated.
Please make any comments regarding the work experience/co-op program at MCC you feel are appropriate.
If there was a position available, would you consider hiring this student as a full-
time employee upon graduation?
n
Yes
n
No
If yes, did you offer this student full-time employment?
n
Yes
n
No
Or did you offer this student part-time employment?
n
Yes
n
No
Has this evaluation report has been discussed with the student?
n
Yes
n
No
Please select all that apply.
n
The co-op student/intern will remain with us for the next semester
n
I will need a co-op student/intern for the next semester
n
Please call me to discuss future co-op and intern opportunities
n
I know of someone else who would like information about the program:
Contact name:
Company name:
Phone:
Email:
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