Date:

Agency/Office:

Supervisor:

Please evaluate the student’s performance based upon the stated learning objective, job description, and/or work assignments.  Please comment on each section of the evaluation.

Please evaluate the student’s performance in the following areas.

E= Excellent       VG= Very Good       AV= Average       M= Marginal       U= Unsatisfactory

Excellent Very Good Average Marginal Unsatisfactory Quality of Work(thoroughness, neatness, accuracy, customer/client services)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Initiative (self-motivated, requires little supervision, seeks increased responsibility, uses creativity)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Dependability (reliable, meets deadlines, accepts responsibility, on time)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Cooperation (relations with colleagues and supervisors)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Self-Awareness (understanding of strengths and weaknesses)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Judgement (asks good questions, makes sound decisions)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Communication (written and oral, clear & precise)

Comments:

Excellent Very Good Average Marginal Unsatisfactory Professionalism (attitude, maturity, appropriate dress, well-groomed)

Comments:

The student has shown skills/aptitude in the following areas:

The student needs improvement in the following areas:

Give one piece of advice to this student to help them continue to develop their leadership skills?

I give permission for a copy of this form to be shared with the student.

Yes    No