Name of Intern: _________________________
Name of University Professor Supervisor: ________________________________
Date: _____________________________
Intern Evaluation Form
University Professor Supervisor
Directions:
Each area has a scale ranging from 0 to 10. A score of 0 to 3 indicates on your part that the intern has not,
to the best of your knowledge, demonstrated competency in that area. A score of 4 to 6 indicates that the
intern has demonstrated a marginal level of competency in that area. A score of 7 to 8 indicates the intern
has demonstrated competency in this area. A score of 9 to 10 indicates the intern has demonstrated
mastery in this area (note: master indicates the intern acts with the same level of judgment, integrity,
insight, and courage as the site supervisor).
Area One:
Judgment: The intern has made judgments based on integrity, courage, and in the best interests of the
parties involved.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Two:
Integrity: The intern has core values and acts with fairness, justice, and responsibility.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Three:
Interpersonal Relations: The intern has been able to effectively communicate with colleagues, teachers,
parents, students, staff members, and other members of the community. This implies the intern has been
willing to listen, moderate previously held positions, and when necessary, stand firm while respecting
diverse opinions.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Four:
Management: The intern has been able to grasp the intricacies of the management components associated
with their placement. These many include budgeting, analysis of data, scheduling, and organizing
programs, meetings, and groups.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Five:
Cultural Diversity: The intern has been able to grasp the importance of supporting cultural diversity. The
intern is proactive in initiating projects to promote cultural diversity and has established a reputation
among all represented cultural groups as a person of fairness, someone who can be trusted.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Six:
Leadership: The intern has demonstrated leadership. The intern builds people, nurtures individuals,
attempts to build an environment where all members thrive, has a strong sense of mission, and is
committed to the profession.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Seven:
Common Sense: The intern has demonstrated they have an intuitive feel of situations and is flexible
enough to deal with a variety of complex situations.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):
Area Eight:
Vision: The intern has communicated a sense of vision regarding the direction and education in their high
school. This vision is consistent with sound educational policy, demonstrates a willingness to confront the
status quo when it’s in the best interest of students, and is directed toward empowering students, parents,
and teachers.
1…2…3…4…5…6…7…8…9…10 (Circle one)
Comments (optional):