EASTERN MICHIGAN UNIVERSITY
PRACTICAL TRAINING
EMPLOYER EVALUATION
 CO-OP
INTERNSHIP  PERCEPTORSHIP  VOLUNTEER  GENERAL EMPLOYMENT
STUDENT NAME ____________________________ MAJOR_______________ EMU STUDENT #E____________
EMPLOYER NAME______________________________________________________________________________
ADDRESS:_________________________________________________________PHONE_____________________
_____________________________________________________________________________________________
City
State
ZIP
SUPERVISOR NAME ________________________________________WORK PERIOD_______________________
(Please print)
TO THE EMPLOYER: Please have the student’s immediate supervisor evaluate the student based on the following
standards. Feel free to include any comments as needed (attach additional sheets if necessary). The supervisor
should review this evaluation with the student following his approved work period. The student should return the
completed form to the Office for International Students and Scholars, 240 Student Center, Ypsilanti, MI 48197,
upon completion of the course and work period. Thank you for your cooperation.
PLEASE CIRCLE ONE LETTER FOR EACH CATEGORY:
RELATIONS WITH CO-WORKERS
ATTITUDE
A.
B.
C.
D.
A.
B.
C.
D.
Works extremely well with others
Works well with others
Has some difficulty working with others
Works very poorly with others
Very positive & enthusiastic
Fairly positive & enthusiastic
Somewhat negative & unenthusiastic
Very negative & unenthusiastic
JUDGEMENT
DEPENDABILITY
A.
B.
C.
D.
A.
B.
C.
D.
Always uses good judgment
Usually uses good judgment
Sometimes uses poor judgment
Consistently uses poor judgment
Always dependable
Usually dependable
Seldom dependable
Never dependable
ABILITY TO LEARN
QUALITY OF WORK
A.
B.
C.
D.
A.
B.
C.
D.
Very quick learner
Fairly quick learner
A fairly slow learner
A slow learner
Superior
Excellent
Always high quality
Usually high quality
Usually poor quality
Always poor quality
Good
Fair
Poor
Overall Performance:
Attendance:
Punctuality:
Comments:
PLEASE COMPLETE ADDITIONAL INFORMATION ON THE BACK SIDE OF THIS FORM
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What suggestions do you have for the student to assist in their professional development?
________________________________________________________________________________
_________________________________________________________________________________
Please note that the student will need to submit a new Curricular Practical Training (CPT) request
to the Office for International Students and Scholars (OISS) for additional work authorization.
Supervisor’s Signature
Date
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
To be completed by student prior to submitting to the Office for
International Students and Scholars (OISS).
I agree________ /disagree_________ with my supervisor’s evaluation.
_________________________________________________________________________________
Student’s Signature
Date
If you do not agree with your supervisor’s evaluation, please comment as to your reasons:
What were the top 3 things you learned from this professional experience?
1.
2.
3.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Thank you for assisting the student in this practical educational experience!!!
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