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Mid-Term Evaluation of Student (BSPH)

Mid-Term Evaluation of Student (BSPH)

MID-TERM EVALUATION

To be completed by Site Supervisor

Thank you for your time and guidance in working with the student, we appreciate your willingness to assist in our internship program.

Fields marked with an asterisk (*) are required.

In order to proceed you must enter the Site Supervisor Code

Site Supervisor Passcode CheckEnter the Site Supervisor Code Provided to You

General InformationStudent Name*Student Concentration*Site Supervisor's Name*Site Supervisor's Email*Place of Internship*Reporting Period - Start Date*Reporting Period - End Date*Hours Worked During Reporting Period*Cumulative Hours Worked to Date*

I. Status of Objectives, as related to the Memorandum of Understanding.Accomplished Activities:*Activities Still in Progress: *

II. Perception of Intern's Personal Attributes and Professional Skills

Please use the number below to indicate the intern's personal attributes and professional skills.

Attendance

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Punctuality

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Cooperation

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Dependability

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Interest and Attitude

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Professional Appearance

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Assertiveness

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Self-Confidence

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Maturity

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Oral Communication

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Written Communication

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Listening Skills

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Background Knowledge

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Accuracy and Thoroughness

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Creativity

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

Initiative

1 = Above Average

2 = Average

3 = Below Average

0 = N/A

III. Evaluation of the performance of the internStrengths Detected*Areas for Improvement *

IV. Suggested Changes in Objectives, Future Activities, if any

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