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William Carey International University

Master of Arts in Transformational Urban Leadership Program

Internship Evaluation Form

Student: _________________________________________________________

Supervisor Name/Position/Contact Information:

__________________________________________________________________

Organization: _________________________________________________

Dates(s): Mid-term: __________________ Final: __________________

Students: Please make one photocopy of this form for your Site Supervisor in the first weeks of your internship.

The Internship Evaluation is designed to provide interns specific feedback for improving their contribution to their hosting organization. It is considered an integral part of the total learning experience afforded by the internship and provides a partial basis for determining the intern’s grade in the course _________________. The evaluation is to be completed at two points in the term: one during the middle of the service term and the other during the final week of service. Conducting an evaluation at the mid-term point enables interns to work through problem areas while encouraging their strengths. It can also provide the basis for renegotiating their service goals for the second half of the term. At both points (mid-term and end-of-term), the evaluation form should be completed independently by the intern’s supervisor/mentor, followed by a one-on-one meeting to discuss ratings and recommend improvements.

Every volunteer brings to the internship different life experiences, as well as different levels of character formation, skill development, and issue-specific knowledge. Consequently, we are more interested in relative growth—relative to where the student-volunteer began—than an absolute measure. Your careful, considered completion of this form is greatly appreciated.

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Directions: Please fill in the date of the mid-term or final evaluation. Then check the appropriate boxes below. Write in summary comments in the spaces provided at the end of the checklist.

MID-TERM: Date:

Date: FINAL

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					Work Habits / Presentation of Self
					Is punctual
					Abides by agency rules and regulations
					Takes initiative
					Is self-reliant
					Dresses appropriately
					Has pleasant demeanor
					Cooperates with staff and clients
					Aware of how perceived by staff and clients
					Service Skills
					Identifies personal interests and skills
					Sets and fulfills goals
					Interacts with socio-cultural appropriateness
					Secures the necessary resources for projects
					Completes assigned tasks
					Attends to detail
					Manages time and energy well
					Meets deadlines
					Follows instructions
					Balances seeking help with self-direction
					Critically reflects on what has been learned
					Personal Qualities
					Demonstrates inquisitiveness: curious and experimental; willing to attempt challenges
					Demonstrates respect for diverse others: open with biases; honors cultural alternatives
					Demonstrates personal warmth: listens attentively, responds sensitively
					Demonstrates flexibility: patient with dull tasks and unanticipated sources of frustration
					Demonstrates dependability: reliable, honest, and accountable for one’s own behavior
					Demonstrates humility: recognizes one’s own limitations; open to self-evaluation, criticism
					Demonstrates compassion: sensitive to and emotionally involved with those served
					Demonstrates justice: considers issues through the eyes of each involved in/affected by them
					Demonstrates creativity: approaches new tasks with a sense of possibility and challenge
					Demonstrates amiability: develops friendships and trust relationships
					Demonstrates tact: polite and respectful when asserting views or performing tasks
					Understandings
					Able to explain the history and present goals and tactics of agency
					Able to explain various organizational roles
					Able to explain the factors that shape the life of host community and those served
					Able to explain the main causes and potential solutions of issue(s) addressed by the agency
					Able to use service experiences to challenge previous assumptions regarding particular issues (e.g., poverty, immigration)

Summary (Final) Assessment

What have been the intern’s major strengths in the placement?

In what areas could the intern improve in order to serve the organization more effectively?

What specific goals, agreed upon at the start of the internship, did the intern appear to achieve? Which goals did the intern not sufficiently work on?