Supervisor Evaluation of HUSR Student’s Performance

1. Default Section

Please answer all of the questions to the best of your ability. The entire survey must be completed at one sitting. You will NOT be allowed to partially save your work and return to it later.

NOTE: Ask your student to provide you with the “End of the Semester Evaluation Verification” form that can be found on the HUSR Fieldwork Office’s website (under the Fieldwork Forms tab).

Question Title

* 1. Student Name:

Question Title

* 2. Please indicate the date you completed this survey.

Enter date according to this format, MM/DD/YYYY. (EX: 04/23/2015 would indicate April 23, 2015)

Date

Question Title

* 3. Semester and Year (EX: Spring 2015):

Question Title

* 4. Please indicate the appropriate Internship Course Number:

396

495

496

Supervisor Evaluation of HUSR Student’s Performance

1. Default Section

Question Title

* 1. Student Name:

Question Title

* 2. Please indicate the date you completed this survey.

Question Title

* 3. Semester and Year (EX: Spring 2015):

Question Title

* 4. Please indicate the appropriate Internship Course Number:

Question Title

* 5. Please provide the name of your agency:

Question Title

* 6. Please provide the name of the program, or programs, in which the intern was involved: