EVALUATION
Office: Science Building 359 Office Hours: Posted on the door Phone: 973 - 720-2274 Fax: 201 - 595-3522 Email: romartin@frontier.wpunj.edu
Student name________________________________________________ Major______________________ Home address____________________________________________________________________________________________ Street City State Zip Co-op/internship coordinator's name_____________________________________________________________________ Name of organization____________________________________________________________________________________ Job supervisor's name____________________________________________ Work phone_________________________ Work address____________________________________________________________________________________________ Street City State Zip Co-op/internship employment dates___________________________________ ___________________________ From To You will be required to establish five or six performance objectives for each cooperative education/ internship period that you complete. These objectives must be originated by you, approved by your job supervisor, and reviewed by your university co-op/internship coordinator. At the end of your cooperative education/internship agreement, you and your job supervisor will rate your progress on each of the performance objectives you have established. The following scale of 1 to 5 is to be used to measure your degree of success in achieving each objective.
* Rating ________________________________________________________________________________ _____________________ Performance Objectives Student | Supervisor ________________________________________________________________________________ | 1. | ________________________________________________________________________________ | | ________________________________________________________________________________ | | ________________________________________________________________________________ | 2. | ________________________________________________________________________________ | | ________________________________________________________________________________ | | ________________________________________________________________________________ | 3. | ________________________________________________________________________________ | | ________________________________________________________________________________ | | ________________________________________________________________________________ | 4. | ________________________________________________________________________________ | | ________________________________________________________________________________ | | ________________________________________________________________________________ | 5. | ________________________________________________________________________________ | | ________________________________________________________________________________ | | ________________________________________________________________________________ | 6. | ________________________________________________________________________________ | | ________________________________________________________________________________ | | ________________________________________________________________________________ | OVERALL EVALUATION: Superior_____ Good_____ Satisfactory_____ Unsatisfactory_____ OTHER COMMENTS: Certification by job supervisor: I hereby certify that this rating constitutes my best judgement relative to the performance objectives established by the co-op/internship student for this training assignment period. Signature______________________________________________________ Date___________ Certification by co-op/internship student: I hereby certify that I have personally reviewed this performance evaluation based on my performance objectives report with my supervisor. Signature______________________________________________________ Date___________ |