F12S13(Including No SU)_Employer/Internship Survey

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* 1. Name of Intern

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* 2. Work Period:

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* 3. Employer:

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* 4. Supervisor:

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* 5. What is the Interns 2 year technical degree?

Architechtural Drafting and Design

Autobody Technicial

Computer Related Field

Engineering

Electronics/Electricity

Fluid Power

HVAC

Health Related Field

Mechanical drafting and design

Manufacturing Related Field

Robotics

Other (please specify)

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* 6. Did the student find this position as an intern or were they already a current employee in your company?

This person was hired as an intern

This person was currently employed and used his/her job as an internship

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* 7. Student Outcomes - This form is a part of the program assessment and is taken very seriously. Not all work assignments will have the factors below; mark N/A if appropriate for internship.

	Excellent	Good	Average	Fair	Poor	N/A
Communication Skills (oral, written, graphic and listening skills)	Communication Skills (oral, written, graphic and listening skills) Excellent	Communication Skills (oral, written, graphic and listening skills) Good	Communication Skills (oral, written, graphic and listening skills) Average	Communication Skills (oral, written, graphic and listening skills) Fair	Communication Skills (oral, written, graphic and listening skills) Poor	Communication Skills (oral, written, graphic and listening skills) N/A
Information Technology Skills (word processing, databases, spreadsheet applications)	Information Technology Skills (word processing, databases, spreadsheet applications) Excellent	Information Technology Skills (word processing, databases, spreadsheet applications) Good	Information Technology Skills (word processing, databases, spreadsheet applications) Average	Information Technology Skills (word processing, databases, spreadsheet applications) Fair	Information Technology Skills (word processing, databases, spreadsheet applications) Poor	Information Technology Skills (word processing, databases, spreadsheet applications) N/A
Scientific & Technical Skills (apply scientific and mathematical knowledge to problems)	Scientific & Technical Skills (apply scientific and mathematical knowledge to problems) Excellent	Scientific & Technical Skills (apply scientific and mathematical knowledge to problems) Good	Scientific & Technical Skills (apply scientific and mathematical knowledge to problems) Average	Scientific & Technical Skills (apply scientific and mathematical knowledge to problems) Fair	Scientific & Technical Skills (apply scientific and mathematical knowledge to problems) Poor	Scientific & Technical Skills (apply scientific and mathematical knowledge to problems) N/A
Technical Area Competence (technical knowledge in work assignment)	Technical Area Competence (technical knowledge in work assignment) Excellent	Technical Area Competence (technical knowledge in work assignment) Good	Technical Area Competence (technical knowledge in work assignment) Average	Technical Area Competence (technical knowledge in work assignment) Fair	Technical Area Competence (technical knowledge in work assignment) Poor	Technical Area Competence (technical knowledge in work assignment) N/A
Economics & Cost Estimating (determine cost advantage or perform cost estimates)	Economics & Cost Estimating (determine cost advantage or perform cost estimates) Excellent	Economics & Cost Estimating (determine cost advantage or perform cost estimates) Good	Economics & Cost Estimating (determine cost advantage or perform cost estimates) Average	Economics & Cost Estimating (determine cost advantage or perform cost estimates) Fair	Economics & Cost Estimating (determine cost advantage or perform cost estimates) Poor	Economics & Cost Estimating (determine cost advantage or perform cost estimates) N/A
Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.)	Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.) Excellent	Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.) Good	Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.) Average	Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.) Fair	Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.) Poor	Total Quality Management (apply and understand TQM, SPC, benchmarking, etc.) N/A
Production & Inventory Management (resource planning, scheduling and application)	Production & Inventory Management (resource planning, scheduling and application) Excellent	Production & Inventory Management (resource planning, scheduling and application) Good	Production & Inventory Management (resource planning, scheduling and application) Average	Production & Inventory Management (resource planning, scheduling and application) Fair	Production & Inventory Management (resource planning, scheduling and application) Poor	Production & Inventory Management (resource planning, scheduling and application) N/A
Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner)	Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner) Excellent	Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner) Good	Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner) Average	Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner) Fair	Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner) Poor	Positive Personal Habits (apply appropriate skills and actions in an ethical and professional manner) N/A
Global & Cultural Awareness (understanding and accepting of cultural and human diversity)	Global & Cultural Awareness (understanding and accepting of cultural and human diversity) Excellent	Global & Cultural Awareness (understanding and accepting of cultural and human diversity) Good	Global & Cultural Awareness (understanding and accepting of cultural and human diversity) Average	Global & Cultural Awareness (understanding and accepting of cultural and human diversity) Fair	Global & Cultural Awareness (understanding and accepting of cultural and human diversity) Poor	Global & Cultural Awareness (understanding and accepting of cultural and human diversity) N/A

Other (please specify)

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* 8. Work Attitude

	Excellent	Good	Average	Fair	Poor	N/A
Demonstrates punctuality by being on time and rarely absent	Demonstrates punctuality by being on time and rarely absent Excellent	Demonstrates punctuality by being on time and rarely absent Good	Demonstrates punctuality by being on time and rarely absent Average	Demonstrates punctuality by being on time and rarely absent Fair	Demonstrates punctuality by being on time and rarely absent Poor	Demonstrates punctuality by being on time and rarely absent N/A
Shows considerable interest in working in the field	Shows considerable interest in working in the field Excellent	Shows considerable interest in working in the field Good	Shows considerable interest in working in the field Average	Shows considerable interest in working in the field Fair	Shows considerable interest in working in the field Poor	Shows considerable interest in working in the field N/A
Approaches work in a resourceful manner	Approaches work in a resourceful manner Excellent	Approaches work in a resourceful manner Good	Approaches work in a resourceful manner Average	Approaches work in a resourceful manner Fair	Approaches work in a resourceful manner Poor	Approaches work in a resourceful manner N/A
Completes an appropriate amount of work	Completes an appropriate amount of work Excellent	Completes an appropriate amount of work Good	Completes an appropriate amount of work Average	Completes an appropriate amount of work Fair	Completes an appropriate amount of work Poor	Completes an appropriate amount of work N/A
Finishes products that meet or exceed standards	Finishes products that meet or exceed standards Excellent	Finishes products that meet or exceed standards Good	Finishes products that meet or exceed standards Average	Finishes products that meet or exceed standards Fair	Finishes products that meet or exceed standards Poor	Finishes products that meet or exceed standards N/A
Uses tact in expressing self and interacting with others	Uses tact in expressing self and interacting with others Excellent	Uses tact in expressing self and interacting with others Good	Uses tact in expressing self and interacting with others Average	Uses tact in expressing self and interacting with others Fair	Uses tact in expressing self and interacting with others Poor	Uses tact in expressing self and interacting with others N/A
Follows directions, instructions and prescribed procedures	Follows directions, instructions and prescribed procedures Excellent	Follows directions, instructions and prescribed procedures Good	Follows directions, instructions and prescribed procedures Average	Follows directions, instructions and prescribed procedures Fair	Follows directions, instructions and prescribed procedures Poor	Follows directions, instructions and prescribed procedures N/A
Accepts and uses suggestions and instruction from supervisor	Accepts and uses suggestions and instruction from supervisor Excellent	Accepts and uses suggestions and instruction from supervisor Good	Accepts and uses suggestions and instruction from supervisor Average	Accepts and uses suggestions and instruction from supervisor Fair	Accepts and uses suggestions and instruction from supervisor Poor	Accepts and uses suggestions and instruction from supervisor N/A
Does not interfere with work being done by others	Does not interfere with work being done by others Excellent	Does not interfere with work being done by others Good	Does not interfere with work being done by others Average	Does not interfere with work being done by others Fair	Does not interfere with work being done by others Poor	Does not interfere with work being done by others N/A
Works cooperatively with others	Works cooperatively with others Excellent	Works cooperatively with others Good	Works cooperatively with others Average	Works cooperatively with others Fair	Works cooperatively with others Poor	Works cooperatively with others N/A
Exercises care in handling and use of tools, equipment, and materials	Exercises care in handling and use of tools, equipment, and materials Excellent	Exercises care in handling and use of tools, equipment, and materials Good	Exercises care in handling and use of tools, equipment, and materials Average	Exercises care in handling and use of tools, equipment, and materials Fair	Exercises care in handling and use of tools, equipment, and materials Poor	Exercises care in handling and use of tools, equipment, and materials N/A
Follows accepted safety rules and policy	Follows accepted safety rules and policy Excellent	Follows accepted safety rules and policy Good	Follows accepted safety rules and policy Average	Follows accepted safety rules and policy Fair	Follows accepted safety rules and policy Poor	Follows accepted safety rules and policy N/A
Seems to enjoy work and working	Seems to enjoy work and working Excellent	Seems to enjoy work and working Good	Seems to enjoy work and working Average	Seems to enjoy work and working Fair	Seems to enjoy work and working Poor	Seems to enjoy work and working N/A
Demonstrates pride in work performed	Demonstrates pride in work performed Excellent	Demonstrates pride in work performed Good	Demonstrates pride in work performed Average	Demonstrates pride in work performed Fair	Demonstrates pride in work performed Poor	Demonstrates pride in work performed N/A
Exhibits appropriate grooming, dress and hygiene practices	Exhibits appropriate grooming, dress and hygiene practices Excellent	Exhibits appropriate grooming, dress and hygiene practices Good	Exhibits appropriate grooming, dress and hygiene practices Average	Exhibits appropriate grooming, dress and hygiene practices Fair	Exhibits appropriate grooming, dress and hygiene practices Poor	Exhibits appropriate grooming, dress and hygiene practices N/A
Works steadily with few breaks	Works steadily with few breaks Excellent	Works steadily with few breaks Good	Works steadily with few breaks Average	Works steadily with few breaks Fair	Works steadily with few breaks Poor	Works steadily with few breaks N/A
Does what he/she says they will do	Does what he/she says they will do Excellent	Does what he/she says they will do Good	Does what he/she says they will do Average	Does what he/she says they will do Fair	Does what he/she says they will do Poor	Does what he/she says they will do N/A
Seeks to improve job performance	Seeks to improve job performance Excellent	Seeks to improve job performance Good	Seeks to improve job performance Average	Seeks to improve job performance Fair	Seeks to improve job performance Poor	Seeks to improve job performance N/A
Has a positive, balanced outlook on life in general	Has a positive, balanced outlook on life in general Excellent	Has a positive, balanced outlook on life in general Good	Has a positive, balanced outlook on life in general Average	Has a positive, balanced outlook on life in general Fair	Has a positive, balanced outlook on life in general Poor	Has a positive, balanced outlook on life in general N/A
Can be counted on to fulfill work responsibilities	Can be counted on to fulfill work responsibilities Excellent	Can be counted on to fulfill work responsibilities Good	Can be counted on to fulfill work responsibilities Average	Can be counted on to fulfill work responsibilities Fair	Can be counted on to fulfill work responsibilities Poor	Can be counted on to fulfill work responsibilities N/A

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