INTERNSHIP PERFORMANCE EVALUATION FORM
Intern’s Details
Name: ___________________________
Evaluation Period: _________________________
Phone: ____________________________
E-mail: ____________________________
University Registration #: _______________________
On-site Supervisor’s Details
Name: ___________________________
Organization Name: ___________________________
Designation: ___________________________
Phone/ Fax: _______________________
E-mail: ___________________________
Quality of Work
- Gets to internship on time and has regular attendance
□ Excellent □ Very Good □ Good □Adequate □ Marginal
- Has a positive attitude towards work
□ Excellent □ Very Good □ Good □Adequate □ Marginal
- Dresses appropriately for the work setting
□ Excellent □ Very Good □ Good □Adequate □ Marginal
- Stays with tasks until completed
□ Excellent □ Very Good □ Good □Adequate □ Marginal
- Completes tasks and assignments accurately
□ Excellent □ Very Good □ Good □Adequate □ Marginal
- Takes responsibility for and is committed to work
□ Excellent □ Very Good □ Good □Adequate □ Marginal
Communication Skills & Interpersonal Effectiveness1. 1.Communicates clearly and concisely
□ Excellent □ Very Good □ Good □Adequate □ Marginal
2. Listens effectively to and understands what others are saying
□ Excellent □ Very Good □ Good □Adequate □ Marginal
3. Interacts well with organization’s staff
□ Excellent □ Very Good □ Good □Adequate □ Marginal
4. Deals effectively with uncooperative or difficult people
□ Excellent □ Very Good □ Good □Adequate □ Marginal
Problem-Solving and Decision-Making
1. Thinks in a disciplined, logical manner
□ Excellent □ Very Good □ Good □Adequate □ Marginal
2. Analyzes problems effectively
□ Excellent □ Very Good □ Good □Adequate □ Marginal
3. Is able to solve problems
□ Excellent □ Very Good □ Good □Adequate □ Marginal
4. Thinks of creative ideas and innovative actions
□ Excellent □ Very Good □ Good □Adequate □ Marginal
5. Takes initiative, where appropriate, as problems arise
□ Excellent □ Very Good □ Good □Adequate □ Marginal
Planning and Organization
1.Sets realistic work goals for assigned tasks
□ Excellent □ Very Good □ Good □Adequate □ Marginal
2. Manages time and tasks effectively
□ Excellent □ Very Good □ Good □Adequate □ Marginal
3. Meets deadlines
□ Excellent □ Very Good □ Good □Adequate □ Marginal
4. Follows directions
□ Excellent □ Very Good □ Good □Adequate □ Marginal
Learning & Potential Growth
1. Takes initiative to seek out new learning experiences
□ Excellent □ Very Good □ Good □Adequate □ Marginal
2. Seeks out answers to questions, when reasonable to do so
□ Excellent □ Very Good □ Good □Adequate □ Marginal
3. Seeks feedback for self-improvement
□ Excellent □ Very Good □ Good □Adequate □ Marginal
4. Accepts constructive criticism non-defensively
□ Excellent □ Very Good □ Good □Adequate □ Marginal
5. Works to strengthen identified weaknesses
□ Excellent □ Very Good □ Good □Adequate □ Marginal
Suggestions/Any other comment:
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Date of Evaluation: ______ Official Stamp & Signature