EMPLOYER EVALUATION FORM

Student / Internee:__________________________________________________________ Organization:_______________________________________________________________ Assessment riteria !e": 1. Unsatisfactory 2. Uncomplimentary . !air ". #ommendable %. &xceptional ( Never demonstrates this ability / does not meet expectations ) ( Seldom demonstrates this ability / rarely meets expectations ) ( Sometimes demonstrates this ability / meets expectations ) ( Us$ally demonstrates this ability / sometimes exceeds expectations ) ( 'l(ays demonstrates this ability / consistently exceeds expectations )

)lease chec* the appropriate n$mber+ if any criteria are not acceptable to this internship experience+ please leave the response blan*. A#i$it" to Learn a. 's*s pertinent and p$rposef$l ,$estions b. See*s o$t and $tili-es appropriate reso$rces c. 'ccepts responsibility for mista*es and learns from experiences Reading / %riting / om&utation S'i$$s a. .eads / comprehends / follo(s (ritten materials b. #omm$nicates ideas and concepts clearly in (ritin/ c. 0or*s (ith mathematical proced$res appropriate to the 1ob Listening ( Ora$ ommuni)ation S'i$$s a. 2isten to others in an active and attentive manner b. &ffectively participates in meetin/s or /ro$p settin/s c. 3emonstrates effective verbal comm$nication s*ills reati*e T+in'ing ( Pro#$em So$*ing S'i$$s a. 4rea*s do(n complex tas*s / problems into mana/eable pieces b. 4rainstorms / develops options and ideas c. 3emonstrates an analytical capacity Pro,essiona$ ( areer -e*e$o&ment S'i$$s a. &xhibits self5motivated approach to (or* b. 3emonstrates ability to set appropriate priorities / /oals c. &xhibits professional behavior and attit$de Inter&ersona$ ( Team.or' S'i$$s a. 6ana/es and resolves conflict in an effective manner b. S$pports and contrib$tes to a team atmosphere c. 3emonstrates assertive b$t appropriate behavior Organizationa$ E,,e)ti*eness S'i$$s a. See*s to $nderstand and s$pport the or/ani-ation7s mission / /oals b. !its in (ith the norms and expectations of the or/ani-ation c. 0or*s (ith appropriate a$thority and decision ma*in/ channels /asi) %or' 0a#its a. .eports to (or* as sched$led and on5time b. &xhibits a positive and constr$ctive attit$de c. 3ress and appearance are appropriate for this or/ani-ation 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 " " " " " " " " " " " " " " " " " " " " " " " " % % % % % % % % % % % % % % % % % % % % % % % %

+ara)ter Attri#utes a. 4rin/s a sense of val$es and inte/rity to the 1ob b. 4ehaves in ethical manner c. .espects the diversity ( reli/io$s / c$lt$ral ) of co5(or*ers

1 1 1

2 2 2

" " "

% % %

O&en ategor" : Industr" S&e)i,i) S'i$$s 're there any s*ills or competencies that yo$ feel are important to the profession or career5field ( represented by yo$r or/ani-ation) that have not been listed in this eval$ation 8 9f so+ please list these s*ills belo( and assess the intern accordin/ly. a. b. c. omments 1If Any): 1 1 1 2 2 2 " " " % % %

omments 1If Any):

O*era$$ Per,orman)e 1 I, I .ere to rate t+e o*era$$ &er,orman)e o, t+e intern 2

Unsatisfactory < ! 1 3 2 3A

)oor " #5 #

'vera/e % #A = 45 > 4

:ood ? 4A @

;$tstandin/ 1< '

'5

Bhis assessment (as revie(ed after six (ee*s of internship on (3ay/6onth/Cear) ______________

&val$ator7s Si/nat$re:________________________Bitle/)osition:____________________

3ate: _____________________________________Belephone:______________________