Mid Stay Evaluation for Trainee/Intern

Survey for the Trainee/Intern

It's hard to believe, but your J-1 program will be half over in the next fifteen days. To comply with the J-1 visa regulations, you are REQUIRED to complete the Mid-Stay Evaluation along with your supervisor. The survey should not take more than 8 minutes.

One of the objectives of this survey is to make sure that your J-1 training or internship program is going well and that your training/internship is going as planned in your official training plan (DS 7002). Therefore, it is very important that you fill out this survey best to your knowledge. If there is anything you would like to share with us which is not covered in this survey, please do not hesitate to contact us http://www.internationalexchangecenter.org/contact-us

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* 1. Please fill in the box below:

Supervisor's name

Trainee Name:

Host Company Name:

Date Training Began:

Today's Date

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* 2. Please indicate to what extent do you agree or disagree with the following statement:

	Strongly Agree	Agree	Disagree	Strongly Disagree
I have learned new skills	I have learned new skills Strongly Agree	I have learned new skills Agree	I have learned new skills Disagree	I have learned new skills Strongly Disagree
The training plan needs to be changed in order to gain competencies as mentioned in the training plan	The training plan needs to be changed in order to gain competencies as mentioned in the training plan Strongly Agree	The training plan needs to be changed in order to gain competencies as mentioned in the training plan Agree	The training plan needs to be changed in order to gain competencies as mentioned in the training plan Disagree	The training plan needs to be changed in order to gain competencies as mentioned in the training plan Strongly Disagree
My training/internship is consistent with the training plan (DS 7002)	My training/internship is consistent with the training plan (DS 7002) Strongly Agree	My training/internship is consistent with the training plan (DS 7002) Agree	My training/internship is consistent with the training plan (DS 7002) Disagree	My training/internship is consistent with the training plan (DS 7002) Strongly Disagree
My host company has helped me adjust to the office environment	My host company has helped me adjust to the office environment Strongly Agree	My host company has helped me adjust to the office environment Agree	My host company has helped me adjust to the office environment Disagree	My host company has helped me adjust to the office environment Strongly Disagree
I have received enough support from the host company to do my tasks as an intern/trainee	I have received enough support from the host company to do my tasks as an intern/trainee Strongly Agree	I have received enough support from the host company to do my tasks as an intern/trainee Agree	I have received enough support from the host company to do my tasks as an intern/trainee Disagree	I have received enough support from the host company to do my tasks as an intern/trainee Strongly Disagree

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* 3. Have you participated in any interesting cultural or community activities since your arrival in the US?

Yes

If you answer yes, please describe your experience

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* 4. What has been your biggest surprise about the United States so far?

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* 5. Please indicate to what extend do you agree or disagree with the following statement:

	Strongly Agree	Agree	Disagree	Strongly Disagree
I found IEC Facebook Page useful	I found IEC Facebook Page useful Strongly Agree	I found IEC Facebook Page useful Agree	I found IEC Facebook Page useful Disagree	I found IEC Facebook Page useful Strongly Disagree
I found IEC Website useful	I found IEC Website useful Strongly Agree	I found IEC Website useful Agree	I found IEC Website useful Disagree	I found IEC Website useful Strongly Disagree
I found IEC Monthly Newsletter useful	I found IEC Monthly Newsletter useful Strongly Agree	I found IEC Monthly Newsletter useful Agree	I found IEC Monthly Newsletter useful Disagree	I found IEC Monthly Newsletter useful Strongly Disagree

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* 6. Please read the disclaimer below:

By signing my name here, I attest that I am the J-1 Trainee/Intern mentioned above. All the information provided herein is correct to the best of my knowledge.

Signature

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* 7. Please read the disclaimer below:

By checking this box, I attest that I have discussed about the progress of my training/internship program with my supervisor.

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* 8. Thank you for filling out the survey. Would you be interested in being featured as the Exchange Visitor of the Month, if you are selected? If Yes, then please provide us with your information in the box below:

Email Address:

Phone Number: