Internship Evaluation Report

INTERNSHIP EVALUATION REPORT Students cannot receive a grade for the internship until this completed form is returned. The FAX# for the Department is 484-646-4180. Thank you.

Intern:______Date:______

Client:______Phone:______

Address:______

City, State, Zip:______

Client Supervisor:______

Evaluation Period: From:______To:______

______

1. What were the Intern’s duties during the evaluation period?

2. What was the quality of the work performed?

Excellent Fair Poor X X X X X

Comments:

3. How would you characterized the Intern’s RESPONSIBILITY and DEPENDABILITY?

Comments:

4. How would you characterize the Intern’s EFFORT and ENTHUSIASM?

Comments: 5. What other comments about this Intern’s performance are important? Able to work with others? Able to assume responsibility? Able to innovate? Able to communicate orally and in writing

6. What are this Intern’s major strengths and weaknesses in your opinion?

7. What would you suggest this Intern do to improve his or her effectiveness?

8. Would your organization be interested in working with another Intern from Kutztown University? If no, why not?

9. Additional comments and/or suggestions?

Supervisor’s Signature:______Date:______