* 1. Cal Poly Intern Name:

* 2. (Your) Supervisor Name:

* 3. Supervisor Title:

* 4. Supervisor Phone and Email:

* 5. Company Name:

* 6. Internship start date?

Intern start date:

* 7. Internship completion date:

Internship completion date:

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

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

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

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

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

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