Date*:
Your Name*:
Your 900#*:
Your E-mail address*:
Your Phone Number*:
Your Internship Major*:
Evaluation Period:
Fall Semester 2011
If you are getting academic credit, who is your Faculty Supervisor:
Listed below are several qualities and skills which have been found to be important in assessing your ability to succeed in an internship. Please indicate how you feel your behavior is best reflected in your internship on a scale from Needs Improvement to Extremely Proficient .
Knowledge*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Dependability*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Interpersonal Relations*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Initiative*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Ability to Work Independently*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Creativity*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Ability to Make Decisions*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Organizational Skills*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Adaptability*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Enthusiasm and Positive Outlook*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Ability to Accept Directions* :
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Communication Skills*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Competence*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
Resourcefulness in Seeking Information*:
5 - Extremely Proficient
4 - Above Average
3 - Acceptable
2 - Somewhat Proficient
1 - Needs Improvement
*Briefly list those tasks which occupied most of your time.
*Do you feel you have met your learning objectives set for this internship?
Yes
No
*Please explain which ones were most and least successfully met.
*Has your internship work experience utilized knowledge and / or skills gained from your Metro State academic studies?
Yes
No
If yes, please explain.
*How has this internship modified or reinforced your future plans, regarding course work, choice of major or career choice.
Please rate your internship with reference to the following:
Orientation to the position*:
5 - Excellent
4 - Above Average
3 - Acceptable
2 - Below Average
1 - Needs Improvement
Supervision / Feedback*:
5 - Excellent
4 - Above Average
3 - Acceptable
2 - Below Average
1 - Needs Improvement
Training received*:
5 - Excellent
4 - Above Average
3 - Acceptable
2 - Below Average
1 - Needs Improvement
Work evironment*:
5 - Excellent
4 - Above Average
3 - Acceptable
2 - Below Average
1 - Needs Improvement
Opportunity to build skills*:
5 - Excellent
4 - Above Average
3 - Acceptable
2 - Below Average
1 - Needs Improvement
*Would you recommend this placement to another student?
Yes
No
*Why or why not?
*Did you receive academic credit for this internship placement?
Yes
No
*Please explain any benefits you have derived from placement through The Internship Center.