This form is to be filled out with copies sent to the student, instructor, and the supervisor.
Phone Number where you can be reached
Name: Mr. Dell McLain
Address: Southeastern Oklahoma State University
Department of Art, Communication & Theatre
Durant, OK 74701
Contact Information: Phone: 580-745-2552, Fax: 580-745-7475, E-mail: firstname.lastname@example.org
Please give the job title of the internship
List the general duties and activities that are part of the internship:
Credits that are earned: 3
Hours to be completed
Time of internship (mm/dd/yyyy-mm/dd/yyyy)
This form is to be filled out and turned in as soon as arrangements for your internship are completed.
Student's Phone Number
Company Phone Number
Date Internship Began
Approximate work schedule
Please list any comments and/or observations that you have regarding the work performance of the student
Summarize your thoughts regarding your internship to date. Include duties you've performed, facts and procedures you've learned, and observations you have made
Were you provided with learning opportunities and was an effort made to train you? Explain.
Has the experience of the internship left you feeling satisfied? Explain.
Do you think this company should be used regularly as a part of this internship program? Explain.
Give a summary of your thoughts and observations that you have made during this internship.
Please indicate below how your intern performed with your company(4=Superior, 3=Good, 2=Average, 1=Below Average, NA=Do Not Know)
Interest in Job
Ability to Learn
Ability to Communicate
Ability to Organize
Ability to Work with Others
Ability to Work Independently
Ability to Work Under Deadline Pressure
Ability to Contribute to the Company
Understanding of Company Procedures
Acceptance and Constructive Use of Criticism
Promise of Success in the Profession
What are the most significant strengths of your intern?
What improvements would you suggest for your intern?
If your company had an opening for a person with the background of this intern, would you hire him/her?
What letter grade do you feel that the intern should receive?
Would you be interested in having another internship in the future?
Do you have any suggestions that could improve this internship program?