Intern Supervisor General Information

Thanks for agreeing to serve as an Intern Supervisor. We hope the experience of helping a potential colleague was personally rewarding and helpful to your institution. Your comments regarding the intern's performance and growth are greatly appreciated. Please complete this form at your earliest convenience.

* 1. Name of Intern

* 2. Name of Supervisor

* 3. Contact Information

* 4. Host Institution

* 5. What was the total number of hours completed by the intern?

* 6. Briefly describe the intern's responsibilities:

* 7. How well did the intern perform the tasks associated with his/her assignment?