Student Intern's Name:
|
|
Please enter your address, phone number, and other contact
information while on this internship:
|
|
Please enter today's date:
|
|
Report number:
|
|
Communication with supervisor:
|
|
Physical well being (food, lodging, general health):
|
|
Opportunity to learn and practice skills:
|
|
Your level of satisfaction with this experience so far:
|
|
|
Assumed level of satisfaction of the experience provider:
|
|
Cooperation with fellow workers:
|
|
| Please rate your work speed: |
|
Please tell me your level of ability to handle responsibility:
|
|
How are you handling suggestions from supervisors?
|
|
What level of technical competence have you achieved?
|
|
In the following boxes, please list jobs or duties you have been
performing. Indicate how many hours you have spent on each job,
and what level of proficiency you have achieved:
|
|
Additional job or duty:
|
|
Additional job or duty:
|
|
Additional job or duty:
|
|
Any comments or thoughts you would like to share:
|
|
Are you keeping a daily journal of your experiences?
|
|
|
Please enter the number of hours worked during this
report period:
|
|
Please enter the total number of hours worked so far on this
internship
|
|
Please indicate number of hours/days absent from duty, and explain
reason for absence. Please remember to clear any absence with your
supervisor, and the department coordinator.
|
|
Firm name and address:
|
|
Owner/Supervisor name:
|
|
Phone number:
|
|
| Your preferred email address (not the employers): |
|
| Initial: |
|
