Enrollee Evaluation Of Work Experience Form Page 2

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Above
Needs
General Employability
Average
Average
improvements
Not Done
Skills
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A. Orientation and Training
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B. Day to Day Supervision
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C. Working Conditions
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D. Cooperation of -coworkers
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E. Encouragement to participate
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F. Adherence to position description
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G. Encouragement to assume new responsibilities
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H. Are you obtaining your training goals?
Comments:__________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
What do you like best about your current assignment?
______________________________________________________________________
What would you change about your current if you could?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Do you have any other comments, needs, or suggestions for improvement?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Supervisor Signature: ______________________________
Date: _____________________
Trainee Signature: ________________________________
Date: _____________________
OWS Signature: __________________________________
Date: _____________________
Return Original to:
Senior Community Service Employment Program
Senior Services Division
PO Box 110209
Juneau AK 99811-0209
F:\Website\employ\Selfeval.doc

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