* 1. Name of Intern

* 2. Work Period:

* 3. Employer:

* 4. Supervisor:

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

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

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

* 8. Work Attitude

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