CPT Supervisor Evaluation Form

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Employer Information

Company/Organization Name:*

Supervisor Full Name:*

First Last

Supervisor Title:*

Supervisor Department:*

Supervisor Email:*

Supervisor Telephone:*

Intern Information

Intern Full Name:*

First Last

Intern Email:*

Job Title:*

Department:*

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Department*

Date Employed*

Date Completed*

Part I. Please use the following rating scale to answer the Rating Questions

Exceptional
Performance far exceeded expectations due to exceptionally high quality of work performed in all key areas of responsibility, resulting in an overall superior quality of work; and either 1) included the completion of a major goal or project, or 2) made an exceptional or unique contribution in support of unit, department, or employer mission.
Exceeded Expectations
Performance consistently exceeded expectations in all key areas of responsibility, and the quality of work overall was excellent. Goals were met.
Met Expectations
Performance consistently met expectations in all key areas of responsibility, at times possibly exceeding expectations, and the quality of work overall was very good. Most critical goals were met.
Below Expectations
Performance did not consistently meet expectations – performance failed to meet expectations in one or more key areas of responsibility, and/or one or more of the most critical goals were not met.
Unsatisfactory
Performance was consistently below expectations in most key areas of responsibility, and/or reasonable progress toward critical goals was not made. Significant improvement is needed in one or more important areas.

Ratings Questions

1. Intern accomplished key duties and responsibilities expected of them*

Please enter a number from 1 to 5.

2. Intern worked collaboratively with others in a positive and productive manner*

Please enter a number from 1 to 5.

3. Intern responded well to instruction and/or constructive criticism from supervisor/ mentor*

Please enter a number from 1 to 5.

4. Intern prioritize and managed their time well*

Please enter a number from 1 to 5.

5. Intern applied knowledge from school to on-the job tasks and real-world problems*

Please enter a number from 1 to 5.

6. Intern was reliable and consistent*

Please enter a number from 1 to 5.

7. I believe this intern will succeed in my industry*

Please enter a number from 1 to 5.

Part II. As an experienced professional, you can offer valuable insight into the student’s personal, professional, and career development. Please answer the following questions

Exceptional
Exceeded Expectations
Met Expectations
Below Expectations
Unsatisfactory

At beginning of the internship (Overall Knowledge)*

Please enter a number from 1 to 5.

At beginning of the internship (Abilities)*

Please enter a number from 1 to 5.

At beginning of the internship (Performance)*

Please enter a number from 1 to 5.

At end of the internship (Overall Knowledge)*

Please enter a number from 1 to 5.

At end of the internship (Abilities)*

Please enter a number from 1 to 5.

At end of the internship (Performance)*

Please enter a number from 1 to 5.

Short Answer

1. What were the intern’s performance strengths?

2. What were the intern’s performance areas for improvement?

3. How did the intern respond to adversity and/or work challenges?

4. What development(s) did you observe in the intern’s skill, knowledge, personal and/or professional performance?

5. Describe the ways in which the intern’s performance benefited your organization.

6. What would you recommend for the intern to do following this experience to make her/him better prepared for this profession and the workplace (e.g., courses, activities, skill development)? Please be specific.

7. Would you hire or recommend this intern to be hired? Why or why not?

8. As an internship supervisor, what comments or feedback do you have regarding your experience?

9. Please include any other comments or information you feel would be helpful feedback for the University of Bridgeport.

Supervisor Signature*

Date Survey Completed*

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Academic Advisor*