Employer Evaluation Form

Instructions: Evaluation form should be completed by student’s immediate supervisor. Evaluation is used to facilitate the student’s professional growth. Please provide as much information as possible and review this with the student.

Fields marked in red are required. The form will not submit if required fields are not filled.

Learning Objectives Quality of Work
1 = successfully met learning objective
2 = met learning objective
3 = made some progress toward meeting learning objective
4 = made little progress toward meeting learning objective
5 = did not make progress toward meeting learning objective
1 = Excellent
2 = Good
3 = Average
4 = Marginal
5 = Needs Improvement
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Overall Work Ethic/ Work Performance

Check appropriate column.

1 = Excellent, 2 = Good, 3 = Average, 4 = Marginal, 5 = Needs Improvement, NA = Not Applicable

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(Printed name serves as a signature for this form)