Student Class Period
St. Francis Preparatory School
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6100 Francis Lewis Blvd. Fresh Meadows, NY 11365
(P) 718-423-8810 (F) 718-224-2108
2015-2016 Christian Service Course
4th Quarter Site Supervisor Evaluation
Dear Site Supervisor:
Thank you for continuing to work with this student volunteer in your program. Your evaluation will be heavily considered in the
determination of his/her quarterly grade. Completed evaluations may be returned to the student who needs to return it to class by
Wednesday, June 1st 2016
Thank you for your time and consideration this year!
Mr. S. Sempowich
Service Instructor
Student’s Name: __________________________________________________
Agency: _________________________________________________________
According to your records what is the TOTAL number of hours served by this student
from 3/24/16 – 6/1/16? This evaluation is due 6/1 so please determine if the student will serve any time
between the time that you complete this form and 6/1 and credit them those hours in advance.
________________________________ hours
Please evaluate this volunteer by checking off the appropriate box.
Excellent
Good
Average Fair
Poor
Comments
Responsibility
Cooperation
Attitude
Punctuality
Attendance
Feel free to use this space or the back of the page to further comment on the contribution of this volunteer.
__________________________________________________________________________________________
Supervisor’s Signature ______________________________________________________
Date_________________________