Visit/Consultation Form
As part of student and site evaluation, faculty may visit or contact the site supervisor. This Visit/Consultation form
may be digitized and data collected may be reported and stored in an online archive that can be viewed by all
internship faculty for purposes of advisement of future interns. The resulting data may be used as part of the
evaluation or assessment of the internship curriculum, course content, equipment/ software/hardware serves
students, and to learn how students may be served better in the future.
1. If the internship could not be visited, when and how did the faculty member communicate with the on-site
supervisor?
a.
Telephone
b.
Email
c.
Web Video Conference
2. Please indicate which description most closely corresponds to the internship you supervised:
a.
Recording studio or other audio production facility
b.
Record company
c.
Publishing company
d.
Live sound or performance venue company
e.
Other – please specify
3. Date of this report
4. Name of Faculty Supervisor
5. Date/time of internship visit
6. Name of company/business
7. Address/location of business
8. Name, title of on-site supervisor
9. Site supervisor’s email
10. Site supervisor’s phone
11. Name of student
Additional Comments:
Signed:___________________________________________________________
Date:___________________