Internship Performance Evaluation Form
Name of Student
:___________________________________________
Name of Internship Site :___________________________________________
For each of the applicable performance areas, mark the box that most closely reflects the
internship student’s performance.
1 = Unacceptable
2 = Needs Improvement
3 = Satisfactory
4 = Above Average
5 = Outstanding
PERFORMANCE AREA
1
2
3
4
5
Initiative
Knowledge of Work
Planning and Organising
Quality of Work
Quantity of Acceptable Work
Accepts Responsibility
Accepts Direction
Attitude
Cooperation
Dependability
Strengths and Superior Performance Incidents:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Areas for Improvement:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
On-Site Supervisor’s Name and Signature: ____________________________
Date
: ____________________________