Evaluation for____________________________________________(student’s name)

Community Placement Site___________________________

Evaluation Period from_________________________ to ___________________________ (starting date) (ending date)

Total Hours Served_____________

Please evaluate the student’s progress and achievements so that we can assist the student improve the quality of his/ her service, if needed.
 

OVERALL PERFORMANCE	NEEDS HELP	AVERAGE	GOOD	EXCELLENT	CANNOT RATE	COMMENTS
Punctual: Arrived on time Times Absent_____Tardy_____
Dependability: prompt, trustworthy, follows directions, meets obligations
Adaptability: catches on quickly, follows detailed instructions, flexibility
Ability to get along: cooperative, well mannered, socially and emotionally stable
Attitude: enthusiastic, team player, positive thinking, desire to improve and learn
Initiative: ability to work without supervision, self-motivating
Responsibility and Judgment: asks for help/advice as needed , decision making skills
Accepts Suggestions: eager to improve, seeks assistance, follows through

If there have been any problems, please describe the circumstances and the outcome:

Signature of Supervisor_________________________ Date_______________________ Phone Number (____)______________