Cal Poly Intern Name:

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* 1. Cal Poly Intern Name:

(Your) Supervisor Name:

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* 2. (Your) Supervisor Name:

Supervisor Title:

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* 3. Supervisor Title:

Supervisor Phone and Email:

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* 4. Supervisor Phone and Email:

Company Name:

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* 5. Company Name:

Internship start date?

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* 6. Internship start date?

Intern start date:
Internship completion date:

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* 7. Internship completion date:

Internship completion date:
What were the total hours worked by this intern?

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* 8. What were the total hours worked by this intern?

What do you feel were the primary strengths of this intern?

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* 9. What do you feel were the primary strengths of this intern?

What do you feel were the primary weaknesses of this intern?

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* 10. What do you feel were the primary weaknesses of this intern?

Would your company hire this intern for full-time employment, now or in the future?

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* 11. Would your company hire this intern for full-time employment, now or in the future?

Generally speaking, are you satisfied that your company benefited from participation in the Internship program, insofar as it involved this student?

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* 12. Generally speaking, are you satisfied that your company benefited from participation in the Internship program, insofar as it involved this student?

What suggestions do you have, if any, for improving the internship program?

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* 13. What suggestions do you have, if any, for improving the internship program?

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