Social Practice Internship Site Supervisor Evaluation

Dear internship supervisor,
Please fill out this internship evaluation as completely as possible to help the faculty advisor assign the student a grade for the internship. This evaluation will be shared with your intern once the faculty advisor has given him/her a grade for the internship.


Please include city, state and zip.
Please indicate if it is a home/work/cell phone.
Please indicate if this is a home/work/cell phone

Please assign a numerical rating as well as adding comments, examples and observations to clarify meaning.

5: Superior Exceptionally high quality work that exceeds expectations
4: Above Average Consistently performs above the requirements of the position
3: Average Performs all duties commensurate with the demands of the position
2: Below Average Falls short of competency in one or more areas of responsibility
1: Poor Has not fulfilled requirements or has done so very poorly

5: Superior4:Above Average3:Average2:Below Average1:Poor
Accuracy and thoroughness
Original and creative thinking
Communication effectiveness
Willingness to learn
5: Superior4:Above Average3:Average2:Below Average1:Poor
Accepts responsibility
Adjusts to non-routine assignments
Cooperative with others
Is able to follow instructions
5: Superior4:Above Average3:Average2:Below Average1:Poor
Takes the initiative, self-starter
Ability to handle deadlines
Demonstrates ability to prioritize set goals
Quality of work produced
For KCAI internship program
Constituent Connections
Please tell us how many of your consitituents benefited from the work the intern did with/for your organization
If yes, we would love to hear from our alumni. Please share our contact information:

By submitting the evaluation, I verify that I supervised this student during his/her internship.