LibertyUniversity

Department of Health Sciences and Kinesiology

1971 University Boulevard

Lynchburg, VA24502

To: Supervisor, Student Interns

From: Beverly Mahoney

Internship Professor

Re: Mid term and Final Evaluations

Dear. Supervisor:

Thank-you so much for devoting your time and expertise to support our student interns. During the course of the semester, I ask that you would complete two short forms. One should be done about mid-way through the semester. (March 15 for spring, June 15 for summer, and October 15 for fall). The second should be done near the completion of the semester (May 1 for spring, August 1 for summer, and December 1 for fall).

We value your time, and consequently these forms should not take long to complete. You can get them to me in any of the three following ways.

1. Ask your intern to email you the electronic versions, and then you can email me the forms as attachments. This is probably the easiest and fastest way to get them to me. Just put the words “Internship Evaluation” and the name of your intern in the subject line. Both the midterm and final forms are very short MS Word documents.

2. Send them to me at the above address via US mail

3. Have your intern hand deliver them to me (they should be in sealed envelopes, bearing your signature across the back seal of the envelope.

I am appreciative of your willingness to have a Health Promotion Intern from LibertyUniversity, and thank you in advance for sharing your expertise with our students. Should you have any questions, at any time, please feel free to contact me by email at or by telephone at 434-582-7447.

Thanks again, and have a blessed day,

Beverly Saxton Mahoney

Beverly Saxton Mahoney, RN, PhD, CHES

Professor, and Director of Health Promotion

LibertyUniversity

Department of Health Sciences

Mid-Internship Evaluation Report by Employer

Student's Name______Date______

Employer______Supervisor______

Please evaluate this Student's work experience progress by checking the appropriate column. Your responses will assist with counseling, grading, and improving the learner's abilities.

Needs Improvement / Average / Above Average
Attendance
Punctuality
Reliability
Ability to Follow Instructions
Quality of Work
Quantity of Work
Judgment
Cost Conscious
Interest in Work
Ability to Work With Others
Ability to Accept Criticism
Courtesy
Cooperation With Company Rules
Flexibility
Appropriate Dress
Cleanliness
Neatness

Comments and specific suggestions for Student's Improvement:

______

______

Signature______Date______

LibertyUniversity

Department of Health Sciences

HLTH 499 - Health Sciences Internship

Final Evaluation of Student by Cooperating Employer

Student's Name______

  1. Was the student receptive and cooperative throughout the internship?

______YesComments:

______No

  1. Did the student make a real effort to comply with the schedules agreed upon?

______YesComments:

______No

  1. Did you have any problems with student absences or tardiness?

______YesComments:

______No

  1. Does this student have the ability to accurately follow instructions?

______YesComments:

______No

  1. Did the student make progress toward professionalism in this area?

______YesComments:

______No

  1. What is your suggested grade for this student? ______

Comments:

Employer's Signature______Date:______

Email ______Phone # ______