HSES Internship Packet

Part II

Mid-Term, Final

Student Evaluations, Student Final Survey

WeeklyActivityLog

Exercise Science

Department of Health, Sport and Exercise Sciences

School of Education

The University of Kansas

Lawrence, Kansas 66045

TABLE OF CONTENTS

Checklist for HSES Internshippage 3

Mid-Term Evaluationpage 5

Final Evaluationpage 7

Student Evaluation of Internship Agencypage 9

Student Final Survey page 10

Weekly Activity Log Informationpage 11

Student Informationpage 12

Weekly Activity Logpage 13

Additional Internship Experiences & Reflectionspage 29

Revised 2/01/12

CHECKLIST FOR HSES INTERNSHIP

During the Internship each Student Intern must complete the following requirements in addition to the on-going responsibilities of the Internship.

1. Maintained a 2.75 overall GPA or a 3.0 GPA to go outside 50-mile radius.

2. Completed a minimum of 26 hours of 300-level and above courses.

3.Consulted with the HSES Internship Coordinator to make sure all paperwork is finalized for theInternship.

4. Enrolled in HSES 499Internship in Sport Management (15 credits) or HSES580: Internshipunder the appropriate line # in your area of specialization: Community Health (12 credits)or Exercise Science (15 credits)

5.Attend the required Internship meeting(s)prior to your Internship semester.

6. Arrive at the Internship Agency at the place, time, and date listed by Internship Agency Supervisor on the Response to Internship Applicationform (Appendix E).

7. Discuss your assignment(s) with your Internship Agency Supervisor and plan to meet with yourInternship Agency Supervisor once a week.

8.Provide the Internship Agency Supervisor with theMid-term Evaluation.

9.Sit in on the Mid-term Evaluationwith your Internship Agency Supervisor and sign the evaluation.

10.Consult with Internship Agency Supervisor to check for any details that must be completedbefore the Internship ends.

11.Submit your Weekly Activity Logs as directed by your HSES Internship Supervisor by the dates indicated.

12.Follow up with your Internship Agency Supervisor to confirm completion and submission of theFinal Evaluation.

13.Complete theStudent Evaluation of Internship Agencyform, the Student Final Survey form and submit them with the Final Evaluationand Weekly Activity Logs.

14.Check with your HSES Internship Supervisor about final deadline dates.

15.Send a "Thank You" letter to the Internship Agency.

16.Start applying for jobs and/or graduate school before Internship is completed.

MID-TERM EVALUATION

(Internship Agency to complete return to HSES Internship Supervisor

at the mid-point of the Internship)

Instructions: The individual filling out this evaluation form should be the person who works primarily with the Student Intern (the person who has spent the greatest amount of time with the Intern) and who is most knowledgeable about the Intern’s performance. Note: This person may or may not be the official Internship Agency Supervisor. At no time should another Student Intern have input into any other Intern’s performance.Please go over this evaluation with the Student Intern and have the Intern sign the evaluation form prior to returning it to the HSES Internship Supervisor.

Student Intern Name:

Rating period: From: To:

Internship Agency:

Internship Agency Supervisor:

Date of Evaluation: __

Signature of Evaluator:

Signature of Student Intern:

Please rate the Student Intern on the following characteristics. A “5” represents high and a “1” is low.N/A indicates that the item is not applicable or there is insufficient information to evaluate that item.

Lowhigh

1)Demonstrates a sincere interest in the profession.N/A1 234 5

2)Works well with people.N/A12345

3)Accepts responsibility.N/A1234 5

4)Is punctual and attentive.N/A12345

5)Completes assigned work.N/A1234 5

6)Accepts suggestions and criticism positively.N/A12345

7)Communicates effectively in writing.N/A1234 5

8)Shows imaginative and creative thinking.N/A1234 5

9)Portrays professional and neat appearance.N/A1234 5

10)Utilizes resources effectively.N/A1234 5

11)Shows initiative and is self-directed.N/A1234 5

(see next page)

12)Is motivated.N/A1234 5.

13)Is organized.N/A1234 5

14)Demonstrates leadership ability.N/A1234 5

15)Demonstrates adaptability.N/A1234 5

16)Demonstrates effective verbal communications.N/A1234 5

17)Follows directions.N/A1234 5

18)Is conscientious.N/A12345

19)Is task-oriented.N/A12345

20)Is a hard worker.N/A12345

21)Overall Rating.N/A12345

Total Points: (Sum ratings from above items) ______

Scale: 94-105 (Excellent), 83-93 (Good), 72-82 (Average), 61-71 (Poor), ≤ 60 (Fail)

Circle the letter grade that you feel best represents the Student Intern’s performance. Please circle only one letter grade. The letter grade should correspond to the ratings scale above.

AA-BB-CC-DD-F

Please provide statements to support your letter grade including positive qualities and areas for improvement.

Comments or suggestions.

FINAL EVALUATION

(Agency to complete return to HSES Internship Supervisor at the end of the internship)

Instructions: The individual filling out this evaluation should be the person who works primarily with the Student Intern (the person who has spent the greatest amount of time with the Intern) and who is most knowledgeable about the Intern’s performance. Note: This person may or may not be the official Internship Agency Supervisor. At no time should another Student Intern have input into any other Intern’s performance.

Please go over this evaluation with the Student Intern and have the Intern sign the evaluation prior to returning it to the HSES Internship Supervisor.

Student Intern Name:

Rating period: From: To:

Internship Agency:

Internship Agency Supervisor:

Date of Evaluation:

Signature of Evaluator:

Signature of Student Intern:

Please rate the Student Intern on the following characteristics. A “5” represents high and a “1” is low.N/A indicates that the item is not applicable or there is insufficient information to evaluate that item.

lowhigh

1)Demonstrates a sincere interest in the profession. N/A1234 5

2)Works well with people.N/A12345

3)Accepts responsibility.N/A1234 5

4)Is punctual and attentive.N/A12345

5)Completes assignments.N/A12345

6)Accepts suggestions and criticism favorably.N/A12345

7)Communicates effectively in writing.N/A1234 5

8)Shows imaginative and creative thinking.N/A1234 5

9)Portrays professional and neat appearance.N/A1234 5

10)Utilizes resources effectively.N/A1234 5

11)Shows initiative and is self-directed.N/A1234 5

(see next page)

12)Is motivated.N/A1234 5

13)Is organized.N/A1234 5

14)Demonstrates leadership ability.N/A1234 5

15)Demonstrates adaptability.N/A1234 5

16)Demonstrates effective verbal communications.N/A1234 5

17)Follows directions.N/A1234 5

18)Is conscientious.N/A12345

19)Is task-oriented.N/A12345

20)Is a hard worker.N/A12345

21)Overall Rating.N/A12345

Total Points: (Sum ratings from above items) ______

Scale: 94-105 (Excellent), 83-93 (Good), 72-82 (Average), 61-71 (Poor), ≤ 60 (Fail)

Circle the letter grade that you feel best represents the Student Intern’s performance. Please circle only one letter grade. The letter grade should correspond to the ratings scale above.

AA-BB-CC-DD-F

Please provide statements to support your letter grade including positive qualities and area for improvement.

Comments or suggestions.

STUDENT EVALUATION OF INTERNSHIP AGENCY

(Student to complete return to HSES Internship Supervisor on the last day of the Internship)

Internship Agency Name:

Internship Agency Supervisor:

Title:

Please rate the Internship Agency on the following characteristics. A “5” represents high and a “1” is low.N/A indicates that the item is not applicable or there is insufficient information to evaluate that item.

lowhigh

1)Able to meet your objectives.N/A1234 5

2)Accepted as a professional by the staff. N/A 1 2 3 45

3)Adequate orientation from agency.N/A1234 5

4)Adequate help with program planning.N/A12345

5)Provided relevant experiences in leadership

and supervision.N/A 1 2 3 4 5

6)Provided relevant experiences in administration

and finance.N/A 12 3 4 5

7)Adequate help with your special project.N/A 1234 5

8)Agency's staff served as professional role models. N/A 1 2 3 4 5

9)Completed appropriate mid-term and final

evaluation of intern's work.N/A 12 34 5

Comments:

low high

Overall rating of the Agency. 1 2 3 4 5 6 7 8 9 10

Student Intern's name:

Semester of Internship:

Student Final Survey

(Please return to your KU Intern Supervisor with your Weekly Logs, Final Evaluation, and Student Evaluation of Internship Agency)

The Exercise Science Program would like to know what your plans are after graduation and a little more information about your Internship experience.

  1. If you are going to graduate school
  2. Please list your planned area of study. ______
  3. Have you been accepted into a graduate program? Yes/No
  4. If “Yes,”What school will you be going to? ______
  5. If you are going to a professional school
  6. Please list your planned area of study (PT, OT, PA, MD, DO, etc.) ______
  7. Have you been accepted into a professional school? Yes/No
  8. If “Yes,” what school will you be going to? ______
  9. If you are going directly into the workforce
  10. Do you have a job lined up? Yes/No
  11. If “Yes,” what company will you be working for? ______
  12. What will be your job title? ______
  13. Would you say that this job is in the field of Exercise Science? Yes/No
  14. If you do not have a job lined up, what are your plans in the next 6 months? ______
  15. As a result of your Internship Experience
  16. Did you get offered a job? Yes/No
  17. If “Yes,” did you accept the job offer? Yes/No
  18. If “Yes,” what company will you be working for? ______

The following questions will provide valuable feedback about the Exercise Science curriculum which will benefit future Exercise Science students.

  1. What are the strengths of the Exercise Science program at KU?
  1. What are the weaknesses of the program, i.e. what areas could be improved?

Please write any additional information that you think would be helpful belowor on the back of this sheet. Thank you.
WEEKLY ACTIVITYLOG INFORMATION

This packet of information is provided for the Student Intern to keep a record of the activities and learning experiences that occurred during the Internship. The intent of the Weekly Activity Log is to provide the HSES Internship Supervisor with information that describes your experiences as a Student Intern. It should also give you an account of how the Internship experiences have progressed. The Weekly Activity Logs are required to receive a final grade in the Internship.

Over the 16-week period of the Internship, you will submit Weekly Activity Logs. The initial set of Weekly Activity Logs for the first 8 weeks of the Internship are due with your Mid-Term Evaluation. The final set of Weekly Activity Logs for the remaining 8 weeks are due with your Final Evaluation. Weekly Activity Logs will be submitted to your Internship Supervisor. Note: A hard copy of your materials is required. Please bring to the office (161) and give to Teresa Aldrich or put in your supervisor’s mailbox. If you are mailing your materials, use the address on your Syllabus.

Instructions

The following instructions must be followed in the completion of your Weekly Activity Log packets.

1)Each page represents one week. Make clear and concise statements about what you did each week. You may use phrases as opposed to long complex sentences as long as you provide a complete picture of your internship experience.

2)Date each page. You must have a brief description of your experiencesfor each week of the Internship.

3)If the HSES Internship Supervisor deems your logs to be inadequate the logs may be returned and the Internship grade withheld. Your Weekly logs must be typed,sufficiently detailed and professional. Handwritten logs will not be accepted.

4)Each week fill in how many hours you worked that week, and what your cumulative total is.

5)Make sure the Student Information Pageon Page 12has been completed before giving the Weekly Activity Log packets to the HSES Internship Supervisor.

NOTE: Check with the HSES Internship Supervisor for the final deadline dates. The mid-term and final deadline dates will be the same for the Weekly Activity Logs and evaluations.

STUDENT INFORMATION

NAME:

ADDRESS:

StreetApt. #City StateZip

PHONE: ( ) E-MAIL:

MAJOR:

INTERNSHIP SITE:

INTERNSHIP AGENCY SUPERVISOR:

1

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 1Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 2Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 3Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 4Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Pleas type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 5Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 6Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 7Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 8Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 9Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):

BRIEFLY EXPLAIN ANY SPECIAL PROJECTS YOU WORKED ON:

PROVIDE GENERAL REFLECTIONS FOR THE WEEK:

WEEKLY ACTIVITY LOG

Name: ______Internship Site: ______

Week #: 10Hrs Worked: ______Cumulative Hrs: ______Date: ______

Note: If any of the following items do not apply to you simply state “None” or “N/A”. DO NOT leave any blanks and be as comprehensive as possible. DO NOT worry if you list the same things from week to week as many jobs are repetitive. Please type the Activity Log.

BRIEFLY DESCRIBE ANY OFFICE EXPERIENCE YOU HAD:

LIST THE TYPES OF EQUIPMENT YOU USED AND/OR LEARNED ABOUT:

DESCRIBE THE TYPES OF CLIENTS YOU WORKED WITH (Do Not Give Client Names):