FORMS
INTERN PROJECT DOCUMENT SHEET – IS 5031
NAME:
Areas of your program of study:
Expected Graduation Date:
PRE-REQUISITES (if required):
Completed:
INTERNSHIP SITE:
Facility:
PERSONAL INFORMATION:
Local address:
Local phone:
E-mail:
Address during Internship:
Phone during Internship:
E-mail:
Any other information you want the committee to know:
VERIFICATION OF INTERNSHIP SITE FORM
I certify that
as an intern at
(student intern name) will serve
(name of facility). This
student will be permitted to work 120 hours during the following time period
of____________________________________________________________.
During this time, the student intern will be involved in the following activities:
Facility Name:
Facility Address:
Supervisor Name:
Supervisor Title:
Supervisor Phone:
Supervisor Fax:
Supervisor Email:
SUPERVISOR SIGNATURE:
Student Signature:
SUPERVISOR EVALUATION OF INTERN FORM
Intern Name:
Name of Internship site:
Name of Supervisor/Title:
Address of site:
To the supervisor: Please evaluate the performance of the intern by circling the appropriate
response under each of the areas below. Your personal comments concerning the intern or the
program are encouraged.
Evaluation Ratings
N/A 1 Poor 2 Fair 3 Average 4 Good 5 Excellent
Personal Qualities
Dresses appropriately & neatly
Acted professional
Shows Initiative
Accepts Criticism
Demonstrates enthusiasm
Is punctual & dependable
Work with individual
Demonstrates knowledge of forensic principles
Gives corrective feedback
Establishes rapport
Works well with other outside professionals
Professional Qualities
Establishes rapport with personnel & supervisor
Demonstrates adequate knowledge
Communicates well
Seeks new knowledge
Management
Manages time efficiently
Care in use of equipment and facilities
Promptness, neatness, and adequacy of records
and reports
Uses good judgment in making decisions
Additional Comments:
N/A
N/A
N/A
N/A
N/A
N/A
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
N/A
N/A
N/A
N/A
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
N/A
N/A
N/A
N/A
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
N/A
N/A
1
1
2
2
3
3
4
4
5
5
N/A
N/A
1
1
2
2
3
3
4
4
5
5
Would you feel confident in hiring this intern for a full time position or in
providing a position recommendation? Yes No
I certify that this student has completed a total of
experience.
hours of internship
Signature of Supervisor
Position/Job Title
Date
NOTE: Please feel free to write any additional comments below. Please see “Interpreting the
Evaluation Scale” for any help in responding to any of the above items.
INTERPRETING THE EVALUATION SCALE
The evaluation scale includes a consideration of each of the items listed below. The intern can
earn a total of 150 points on this evaluation and it is worth 30% of their total grade for the
internship. The intern is rated, in terms of a 5 point scale, on each item. The qualities to be rated
may be further defined as follows:
1. PERSONAL QUALITIES
a)
b)
c)
d)
Dresses professionally, neatly, & appropriately.
Shows initiative (does more than is assigned or expected).
Accepts constructive criticism and works toward improvement.
Punctual- arrives on time or early and carries out assigned tasks.
2. WORK WITH INDIVIDUALS
a)
b)
c)
d)
Demonstrates adequate knowledge of the subject area.
Demonstrates knowledge in over-all subject area.
Gives corrective feedback in a positive manner.
Establishes a good rapport with individuals.
3. PROFESSIONAL QUALITIES
a)
b)
c)
d)
Establishes good rapport with personnel and supervisor.
Demonstrates knowledge of basic principles.
Uses adequate verbal and non-verbal communication skills.
Continues to pursue and apply new knowledge.
4. MANAGEMENT SKILLS
a)
b)
c)
d)
Uses time efficiently.
Shows knowledge of care and use of equipment.
Demonstrates promptness, neatness and adequacy of records and reports.
Uses good judgment in management and decision making.
Student Name:
CHECKLIST
**Please place this sheet at the beginning of the document.
DO NOT WRITE ON THIS FORM
The Committee will use this form in evaluating the
document.**
Page one - Intern portfolio checklist
Page two - Title page
Page three - Current resume
Page four - Any evaluations received from site
Section One - Description of Facility
Section Two - Duties
Section Three – Equipment
Section Four – Project Documentation
Section Five – Summary & Evaluation
GRADE:_________
COMMENTS: