HIED 5643 Site Supervisor Evaluation: Reflective Practice in Higher Education and Student Affairs

Student Name

Internship Semester

Fall
Spring
Summer

Internship Year

Professional Site Supervisor Name

Professional Site Supervisor Title, Institution, and Unit/Office

Site Supervisor Email

HIED Internship Faculty Name

In order to determine the student's final grade for the internship, please evaluate the student and the experience. Your survey evaluation responses will be sent to the Faculty Internship Advisor and Program Coordinator.

Please rate the level of accomplishment attained by the student using the following scale:

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations
3 = Exceeded minimal performance expectations
4 = Performed at an exceptional level

Not applicable

In order to determine the student's final grade for the internship, please evaluate the student and the experience. Your survey evaluation responses will be sent to the Faculty Internship Advisor and Program Coordinator.

Please rate the level of accomplishment attained by the student using the following scale:

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations
3 = Exceeded minimal performance expectations
4 = Performed at an exceptional level

Not applicable

Professional Job Behavior

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

Please share any additional details regarding the student's professional job behavior.

Please rate the level of accomplishment attained by the student using the following scale:

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations
3 = Exceeded minimal performance expectations
4 = Performed at an exceptional level

Not applicable

Please rate the level of accomplishment attained by the student using the following scale:

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations
3 = Exceeded minimal performance expectations
4 = Performed at an exceptional level

Not applicable

Communication and Human Relations Skills

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

1 = Did not meet minimal performance expectations

2 = Met minimal performance expectations

3 = Exceeded minimal performance expectations

4 = Performed at an exceptional level

Not applicable

Please share any additional details regarding the student's communication and human relations skills.

Please share any additional details regarding the student's administrative competencies.

Do you believe the student accomplished the goals as set forth in the Internship Contract?

Yes
No

Please share any additional details regarding the student accomplishing the goals as set forth in the Internship Contract.

Did the student fulfill your expectations for completing the internship work?

Yes
No

Please share any additional details regarding the student fulfilling your expectations for completing the internship work.

Please use this space if there is anything else you would like to share regarding student feedback or about the internship process overall.

Overall Evaluation of the Student's Internship Performance

In considering if the student intern successfully completed the internship goals and achieved a reasonable level of competence, I recommend the following grade:

Site Supervisor Signature and Date (Month/Day/Year)

Sign Here

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