UNIVERSITY OF CALIFORNIA, BERKELEY BERKELEY DAVIS LOS ANGELES MERCED RIVERSIDE SAN DIEGO SAN FRANCISCO SANTA BARBARA . SANTA CRUZ DEPARTMENT OF CIVIL AND ENVIRONMENTAL ENGINEERING PROFESSIONAL DEVELOPMENT CERTIFICATION PROGRAM Externship Evaluation Form is to be filled out by the student and turned in to the Undergraduate Advisor in 750 Davis Hall Name of Student: ______________________________________________________________________ Name of Agency, Company or Research Group: ____________________________________________________________________________________ Names & Title of Supervisor: ___________________________________________________________ Dates of Externship: ___________________________________________________________________ Describe, in more than 100 words, what work you observed. Discuss whether the externship affected your ideas about engineering practice. (Can be listed on a separate piece of paper and attached) _______________________________________________ Signature _______________ Date