Important Note: All 240 hours must be completed AND all reports must be submitted by Friday, December 5th by 5:00 PM. There are no "Incompletes" or extensions.

Name of Student: ____________________________________________

Agency Name: _____________________________________________

Supervisors Name: _____________________________________________

Period Covered by Rating: From: ___________ To: _______________

Date of Evaluation: _________________

Total Number of Hours Worked By the Student: _____________________

This rating should be made with care and fairness for the interest of the student. Reflect carefully upon the student's performance and make an honest judgement of their job performance. Base your judgement on the entire period covered and not upon isolated incidents.

As a guideline, the following categories may be helpful. Insert the appropriate rating in the blank provided for each area to be rated.

OUTSTANDING....Consistently exceptional in fulfilling requirements.

GOOD...........Regularly meets and occasionally exceeds minimum requirements.

FAIR...........Does passable work but does not extend her/himself.

POOR...........Fails to meet minimum requirements.

1. Knowledge of Position: Understanding of the job requirements, the student's place in the organization, and job expectations.

Rating: __________

Strong Points:

Suggestions for Improvement:

2. Productivity: Use of time and facilities. Volume and nature of work produced. Planning and follow-through.

Rating: __________

Strong Points:

Suggestions for Improvement:

3. Quality of Work: Organization, thoroughness, accuracy, neatness, foresight, soundness of decisions, clarity of expression.

Rating: __________

Strong Points:

Suggestions for Improvement:

4. Relationships with Clientele: Respect, tact, insight, effectiveness, courtesy.

Rating: __________

Strong Points:

Suggestions for Improvement:

5. Communication Skills: Ability to communicate effectively with other staff members, and ability to secure acceptance of ideas, methods, procedures, and plans by other staff members. Consideration of other viewpoints.

Rating: __________

Strong Points:

Suggestions for Improvement:

6. Relations with Other Departments: Knowledge of the functions of other departments, service areas, and resources serving your clients. Ability to coordinate and cooperate with these other departments.

Rating: __________

Strong Points:

Suggestions for Improvement:

7. Writing Ability and Oral Expression: Degree of skill and ability to express thoughts on paper, reports, projects; command of language and ability to speak to others.

Rating: __________

Strong Points:

Suggestions for Improvement:

8. Responsibility: Dependability; ability to meet schedules, follow-through, and attend to instructions.

Rating: __________

Strong Points:

Suggestions for Improvement:

9. Independent Functioning: Ability to perform without constant supervision and to function constructively on own initiative when necessary.

Rating: __________

Strong Points:

Suggestions for Improvement:

10. Personal Habits: Attention to appearance, including suitability of attire and grooming.

Rating: __________

Strong Points:

Suggestions for Improvement:

11. Attendance and Punctuality: Regularity of attendance, promptness of reporting absence, tardiness, and time off for illness or personal business; clock watching.

Rating: _________

Strong Points:

Suggestions for Improvement:

12. Attitude: Loyalty, interest, and approach to internship, associates, public, and the agency. Ability to comply with established procedures and policies.

Rating: __________

Strong Points:

Suggestions for Improvement:

13. Judgement: Possesses common sense, distinguishes important from unimportant, evaluates the problem before deciding.

Rating: __________

Strong Points:

Suggestions for Improvement:

14. OVERALL STUDENT PERFORMANCE FOR YOUR AGENCY.

Rating: __________

Strong Points:

Suggestions for Improvement:

ADDITIONAL COMMENTS

Student Comments:

Supervisor Comments:

Supervisor's Signature:_______________________________ Date: _________

If you have any questions concerning this evaluation please contact: Dr. Charles Hammersley at (928) 523-6655. Thank you for your time and assistance.

Please complete and return via:

E-mail to: charles.hammersley@nau.edu

or

Fax (928) 523-2275

or

Mail to: Dr. Charles Hammersley, Northern Arizona University, Parks and Recreation Program,

70 McConnell Drive, Room 201, PO Box 15016, Flagstaff, AZ  86011-5016

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