LIS Practicum Placement Supervisor Evaluation

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1. Name (Required.)

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2. Email (Required.)

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3. Title

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4. Name of Student Supervised

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5. Please rate the student on the characteristics listed below using the following scale:

A= Above Average
B= Average
C= Below Average
F= Low
(Required.)

	A	B	C	F
Initiative	Initiative A	Initiative B	Initiative C	Initiative F
Dependability	Dependability A	Dependability B	Dependability C	Dependability F
Decision making skills	Decision making skills A	Decision making skills B	Decision making skills C	Decision making skills F
Interactions with colleagues	Interactions with colleagues A	Interactions with colleagues B	Interactions with colleagues C	Interactions with colleagues F
Interactions with clients	Interactions with clients A	Interactions with clients B	Interactions with clients C	Interactions with clients F
Desires to learn more	Desires to learn more A	Desires to learn more B	Desires to learn more C	Desires to learn more F
Professional appearance	Professional appearance A	Professional appearance B	Professional appearance C	Professional appearance F
Quality of work	Quality of work A	Quality of work B	Quality of work C	Quality of work F
Attitude	Attitude A	Attitude B	Attitude C	Attitude F
Professionalism	Professionalism A	Professionalism B	Professionalism C	Professionalism F
Communication skills	Communication skills A	Communication skills B	Communication skills C	Communication skills F
Overall rating	Overall rating A	Overall rating B	Overall rating C	Overall rating F

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6. Please comment on the student’s strengths.

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7. Please comment on the student’s areas for improvement.

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8. Please provide any other comments about the student not already covered.

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9. Do you believe our School has adequately prepared this student for professional work? If not, why?

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10. Do you have any thoughts on improving our practicum?

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11. Would you be willing to host students in the future?