Fillable Printable Student Evaluation Form Sample
Fillable Printable Student Evaluation Form Sample
Student Evaluation Form Sample
STUDENT EVALUATION FORM
Student Name
Primary Supervisor’s Name
Site Name
Practicum hrs/wk
Mid-Year (due Jan 15
th
) End-of-Year (due June 15
th
) Revision (du e J u l y 15
th
)
Eva luation Period
Please rat e the student’s performance in the followin g ar eas by checking the appropriate column for each item.
Code: E = Exceptional EE = E xceeds E xpectation ME = Meets Expectation I = Improvement Needed U = Unsatisfactory
N/O=No Opportunity to Observe
E
EE
ME
I
U
N/O
I.
English & Literacy
A. Readin g & Writing Skills:
Grammar and Usage
Demonstrates Writing Strategy
Problem Solving and Conceptualization
Ab ility to Draw Conclusions
B. Listenin g & S peaking
Ab ility to Formulate Impressions
Ability to Communicate Feedback
Contextual Understanding
Ability to De liv er Presentatio n
Quality of Written Content
Effective Communication Skills
II.
Mathematical Skills:
Concepts & Procedures
Problem Solvin g
Communicating Reasoning
Modeli ng & Data Analysi s
Model Concepts for Real World Application
III.
Research Skills:
Problem Conceptualization
Investigation of Topic
Data analysis skills
Qu ality o f writing
IV.
Personal/ Ethical:
Motivation to learn; effort extended toward skill mastery
Ability to work independently
Completion of work in a timely manner
Carefulness of work
Dependability
Professional manner with peers and supervisors
Knowledge of and adherence to ethical st andards
Sen sitivity to cultural diversity of others
V.
Responsiveness to Supervision:
Comes prepared for learning
Openness to supervisory feedback
Inco r porates supervi sory feedback
Strengths: Please share with us your general impressions of the student’s particular academic, professional, and/or personal
strengths. What improvements has the student made during his/her time with you?
Weaknesses: What areas do you feel represent relative weaknesses for this student? What would you like this student to continue to
work on?
What would you recommend as an overall rating for this student to date?
Exceptional: displays exceptional competence, functions autonomously, professional level
Excellent: co nsistently exceeds expectations for acceptable work, functions with high autonomy
Abo ve average : frequently exceeds expectations for acceptable work, functions with high autonomy
Average: meets expectat ion s, average comp etence, fu nctions well with supervision
Below average: gen er all y meet s expect ations, function s adequately wi th close supervision
Poor: occasionally meets expectations, requires much supervision, needs improvement
Very poor: seriously below expectations, requires extensive remediation
Important note: end-of-year evaluat io ns are considered provisional
in the sense that supervisors will have an opportunity to
revise evaluations in the period immediately fo llowing the conclusio n of the p ra cticum placement.
*Important: Forms are not
considered com plete unless they
co ntai n al l t hree signatur es.
Supervisor’s Signature
Date
Student’s Signature upon review and discussion of this form
Date
Ment or ’s S ig nature upon rev iew and disc us s ion of this f or m
Date
