Directions: Circle a response for each row below. Total the points by using the numerical value for each column. 4 Points 3 Points 2 Points 1 Point Quality of Work Superior Very Good Average Poor Knowledge of Excellent Good Adequate Insufficient Work Very Shows great Shows normal Indifferent; Work Attitude enthusiastic interest interest uninterested Attendance/ Attends daily; Occasionally Warned for Frequently absent or Punctuality always on time absent or late tardiness/truancy late Makes Needs occasional accurate, Often needs help Cannot make own guidance from Ability with decisions decisions supervisor/others decisions Industrious; Works steadily; Persistent in Avoids work; not Industry (Diligence) works extra good effort efforts persistent Alert to Seeks Regular work opportunities; Needs explanation of Work Initiative additional tasks; performed makes good routine work highly motivated promptly suggestions Organizational Highly capable Disorganized Fairly organized Disorganized often Ability of organizing occasionally Positive; takes Sometimes Inclined to be Attitude Toward active friendly Pleasant, polite difficult to work quarrelsome, Others interest in with uncooperative others Acceptance of Welcomes Accepts willingly Accepts under Avoids responsibility responsibility without protest protest whenever possible Responsibility Total Points Received on Page 1 & 2: _________ _______________ Worksite Supervisor Signature Date
Directions: Circle a response for each row below. Total the points by using the numerical value for each column. 4 Points 3 Points 2 Points 1 Point Quality of Work Superior Very Good Average Poor Knowledge of Work Excellent Good Adequate Insufficient Work Attitude Very enthusiastic Shows great interest Shows normal interest Indifferent; uninterested Attendance/ Punctuality Attends daily; always on time Occasionally absent or late Warned for tardiness/truancy Frequently absent or late Ability Makes accurate, decisions Needs occasional guidance from supervisor/others Often needs help with decisions Cannot make own decisions Industry (Diligence) Industrious; works extra Works steadily; good effort Persistent in efforts Avoids work; not persistent Work Initiative Seeks additional tasks; highly motivated Alert to opportunities; makes good suggestions Regular work performed promptly Needs explanation of routine work Organizational Ability Highly capable of organizing Fairly organized Disorganized occasionally Disorganized often Attitude Toward Others Positive; takes active friendly interest in others Pleasant, polite Sometimes difficult to work with Inclined to be quarrelsome, uncooperative Acceptance of Responsibility Welcomes responsibility Accepts willingly without protest Accepts under protest Avoids responsibility whenever possible Total Points Received on Page 1 & 2: _________ Worksite Supervisor Signature _______________ Date
CCSD-Internships-Supervisor-Evaluation-Forms.docx