INTERNSHIP MANUAL
URBAN AND REGIONAL STUDIES INSTITUTE
497/697
Minnesota State University, Mankato
Student Name: ____________________________________
Internship Coordinator: _______________________________________________
MINNESOTA STATE UNIVERSITY, MANKATO
Urban and Regional Studies Institute
Application Receipt
On _____________________ (date)
________________________________________ (student name)
turned in a completed application for an internship for the _________________________(semester)
__________ (year) term.
Prior to this I also (have, have not) received a letter of confirmation of acceptance from the internship
providing organization. Electronic authorization will be entered into MARS immediately for the student,
authorizing the student to register for _____________________ semester hours for the internship.
_____________________________________________________ ____________________________
Signature of Internship Coordinator
Date
_____________________________________________________ ____________________________
Student’s Advisor
Date
XC: M. Manderfeld
JOURNAL
Please keep an accurate and complete journal. (photo copy additional pages to complete)
Day _________ Date _______________________
Arrival Time __________________ am / pm
Departure Time _________________ am / pm
Total time spent at site _________________________hrs. __________________min.
Supervisor ______________________________________________________________________
Assignment (location, department) __________________________________________________
Describe duties performed or observed:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Minnesota State University, Mankato
Urban and Regional Studies Institute
INTERSHIP PROGRAM
Intern Rating Report Explanation
The following evaluations are intended to assist us in evaluating the internship experience. Your
comments will aid us in counseling the student with the goal of improving future performance of the
student. You may either complete the forms and leave them in the student’s manual or return them
directly to the address listed below. There are several copies of the evaluation form so they may be
filled out by either coordinator at the end of the internship or by each person the intern works with. If
more forms are needed, we will gladly provide them. This is your form and although there are things
listed we would like you to address, this is certainly not meant to limit your comments. Please, feel free
to add whatever comments you feel are appropriate regarding the student’s performance or the
program itself. Your input is welcomed and encouraged. We consider you and your organization a
valuable contributor to the student’s education.
Please return to:
Dr. Janet Cherrington, Internship Coordinator
Urban and Regional Studies Institute
Minnesota State University
106 Morris Hall
Mankato, MN 56001
Or leave a phone message at 507-389-1714
Minnesota State University, Mankato
Urban and Regional Studies Institute
Intern Rating Report – page 1
(complete for mid-term assessment and for final assessment)
Date Completed:
________________________
Intern: _______________________________________________________________
Internship Provider: ____________________________________________________
Report Completed by: ___________________________________________________
Report for period of: _________________________ to _______________________
1. Never
2. Seldom
3. Occasionally 4. Frequently 5. Always NA not applicable
To what extent do you think (circle appropriate response) . . . . . .
1. The intern demonstrates basic knowledge of their field.
1
2
3
4
5
NA
2. The intern works cooperatively with other personnel.
1
2
3
4
5
NA
3. The intern asks appropriate questions when in doubt.
1
2
3
4
5
NA
4. The intern communicated effectively with other personnel/public.
1
2
3
4
5
NA
5. The intern showed sincere interest in the position.
1
2
3
4
5
NA
6. The intern respects confidentiality.
1
2
3
4
5
NA
7. The intern uses professional judgment in selecting, interpreting and
reporting data.
1
2
3
4
5
NA
8. The intern recognizes own strengths and weaknesses.
1
2
3
4
5
NA
9. The intern demonstrates a high level of initiative.
1
2
3
4
5
NA
10. The intern appropriately completes reports (verbal/written).
1
2
3
4
5
NA
Minnesota State University, Mankato
Urban and Regional Studies Institute
Intern Rating Report – page 2
The following is a list of attributes that are considered by many to be important in an employee.
Some or all may apply to the actual assignment or the intern you are rating. Please rate
performance on these items. Please circle one.
1. Unsatisfactory 2. Below average 3. Average 4. Above average 5. Excellent
1.
Commitment
NA
1
2
3
4
5
NA
2. Self-motivation
1
2
3
4
5
NA
3. Maturity
1
2
3
4
5
NA
4. Honesty
1
2
3
4
5
NA
5. Timely completion of assignments
1
2
3
4
5
NA
6. Appearance
1
2
3
4
5
NA
7. Written communications skills
1
2
3
4
5
NA
8. Oral communications skills
1
2
3
4
5
NA
9. Respect for others
1
2
3
4
5
NA
10. Empathy
1
2
3
4
5
NA
11. Initiative
1
2
3
4
5
NA
12. Bearing
1
2
3
4
5
NA
13. Neatness
1
2
3
4
5
NA
14. Willingness to learn
1
2
3
4
5
NA
15. Retention of learning
1
2
3
4
5
NA
16. Acceptance of criticism
1
2
3
4
5
NA
17. Dependability
1
2
3
4
5
NA
18. Ability to carry out complex instructions
1
2
3
4
5
NA
19. Cooperation
1
2
3
4
5
NA
20. Goal setting
1
2
3
4
5
NA
Minnesota State University, Mankato
Urban and Regional Studies Institute
Intern Rating Report – page 3
How could the intern most improve his/her effectiveness?
Additional comments regarding the intern.
I would or would not recommend this person as a result of my experience with them during the
internship. Please comment.
Program Comments
How could we as an institution change to improve the effectiveness of future interns.
How could we improve the intern program itself or make the program more attractive to your
organization?
Does your organization have needs that you would like to see met by our institution or more specifically
by our department (i.e. seminars, custom non-credit classes, etc.)?
Thank you for your time, dedication and honesty.