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Bonaventure University Intern Evaluation Form for Internship

Site Supervisors Evaluation Form

University Supervisors Evaluation Form
The criteria evaluated on this form are based upon and reflective of the
Knowledge, Skills and Dispositions mentioned on pages 4-5 of the
Internship Guide. They are coded by their appropriate K, S, and D numbers
below.
Please check the appropriate box indicating which evaluation form you are
filing. Make copies of this evaluation form for each supervisors as well as
the interns evaluation.
Interns Name

Kelly Dunham

Site Supervisors Name

Michael Roche

University Supervisors Name

I

OVERALL EVALUATION

Please indicate a general evaluation of the accomplishment of the stated

competencies of the internship.
(Check One)
Outstanding
Unsatisfactory

x Very Good

Good

Satisfactory

COMMENTS: (Use additional sheet if necessary)

Kelly has been responsive to any and all suggestions for growth during this phase
of her internship.

II PROFESSIONAL CRITERIA

For each of the criteria listed below, please provide both a numerical selfevaluation and any pertinent comments about the internship experience.

For numerical evaluation, use the following scale:

5Outstanding
A

4 - Very Good

3 - Good

2 - Satisfactory

1Unsatisfactory

4
LEADERSHIP ABILITY (K1, K2, K3, S3, D1, D4, D6 - e.g. ability to
inspire other, set and reach goals, create positive action, solve problems,
etc.)

COMMENTS:
Kelly has looked for opportunities to expand her role as a leader at the Elementary
level, accepting areas such as discipline, PTO and RTI.

4
PROFESSIONAL MOTIVATION (D3, D4 - e. g. clear goals, high level
of professional interest and motivation, etc.)

COMMENTS:
Kelly consistently looks for ways to make the most of her internship, seeking out
new experiences.

4
PERSONAL CHARACTERISTICS (D2, D5, D6 - e.g. sense of humor,
poise, self-control, ability to handle crises and stress, honest, etc.)

COMMENTS:

Again, Kelly has willing accepted all new assignments during her internship and
sees the assignments as a challenge and a way to grow professionally.

3
INTERPERSONAL RELATIONS (D2, D3, D4, D4, D6 - e.g. ability to
relate to others, work with groups, acceptance of criticism, respect for
others, etc.)

COMMENTS:
Kelly effectively works with the people she encounters.

4
PROFESSIONAL COMPETENCE (K1, K2, K3, S1, S2, S3, D1, D2, D3,
D4, D6 - e.g. successful completion of tasks and assignments,
demonstrates understanding of nature of administration, includes
dependability, demonstrates initiative, assumes responsibility, able to
work independently, punctual, etc.)

COMMENTS:
All tasks assigned have been completed in a timely manner.

3
WRITTEN COMMUNICATION (S1, S2 - e.g. fluency, accuracy,
command of the language, timeliness, grammar, etc.)

COMMENTS:
All communications have been clear and concise.

3
ORAL COMMUNICATION (S1, S2 - e.g. fluency, poise ability to
articulate, enunciation, grammar, etc.)

COMMENTS:
As with her written communication, Kelly makes certain that her oral
communication is clear and concise, and checks with all parties involved to make
sure everyone understands.

H ADDITIONAL COMMENTS (Comments/observations not covered in prior

question areas)

Michael Roche
Signature

07/09/14
Date