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Experience Provider Report

(To be completed by the Internship Provider, evaluating the student intern)



Student Intern's Name:
Please indicate the number of conferences you have had with the student:
1) Punctuality:
2) Willingness to learn:
3) Dependability:

4) Thoroughness of work:
5) Acceptance of constructive criticism:

6)Personal appearance:

7) Cooperation with fellow workers:
8) Work speed:
9) Responsibility:
10) Acceptance by supervisors:
11) Acceptance by others:
12) Technical competence:
13) Additional comments:
Firm name and address:
Owner/Supervisor name:
Contact Email:
Phone number:


If it does not submit, please print or save this form and send it to: Ben Romney, BYU Idaho, 525 S Center St. 1120 Rexburg ID 83460 OR romneyb@byui.edu OR fax to (208) 496-6017




Applied Plant Science Department

Rexburg, ID 83460-1120

(208) 496-4581