Appendix D

Radford University Department of Sociology

Student Performance Evaluation

______Mid-semester ______Final (check one)

Intern Name: ______

Agency Name:______

Intern’s Major Responsibilities: ______

______

Agency Representative: Please evaluate the student in each of the following areas. Upon completion of the evaluation, please review the results with the student. The review should emphasize major strengths as well as areas in need of improvement and the student’s potential for continued work in the field. In the area provided under each evaluation factor, please write a brief justification for each rating that is placed in the “Needs Improvement” or in the “Exceeds Expectations” category.

Needs Meets Exceeds

Factors Improvement Expectations Expectations

1.  Quality of Work:

·  Completeness ______

·  Accuracy in oral expression ______

·  Accuracy in written expression ______

·  Overall quality of work ______

______

______

2.  Quantity of Work

·  Amount of work completed ______

·  Promptness in completing

assigned tasks ______

______

______

Needs Meets Exceeds

Factors Improvement Expectations Expectations

3.  Initiative

·  Resourcefulness ______

·  Self-reliance ______

·  Degree of initiative ______

·  Degree of supervision

needed ______

______

______

4.  Dependability

·  Reliability ______

·  Promptness and attendance ______

·  Ability to follow agency

rules and regulations ______

______

______

5.  Relations with people

·  Effectively communicates

with clients ______

·  Effectively communicates

with staff ______

·  Functions as an effective

team member ______

______

______

6.  Job knowledge. Understanding of

·  Job responsibilities ______

·  Agency functions ______

·  Assigned tasks ______

______

______

7.  Professionalism

·  Dress is appropriate

for work setting ______

·  Behavior is appropriate

to work setting ______

·  Complies with the code of

ethics appropriate for the

work setting ______

______

______

Please indicate an overall rating of performance:

Needs Improvement Meets Expectations Exceeds Expectations

Agency Remarks: ______

______

______

______

______

______

______

Signature: ______

Agency Representative (Evaluator) Date

Student Remarks: ______

______

______

______

______

______

______

Signature: ______

Student Date

Upon completion, please email to or mail to:

Dr. Beth Lyman

Internship Coordinator

Department of Sociology

P. O. Box 6948

Radford University

Radford, VA 24142