Supervised Internship Evaluation Report

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Intern Information	Supervising Teacher Information
Name:	Name:
Phone:	Phone:
Email:	Email:
	School Address:

Questions for the Supervising Teacher

1. On average, how many hours per week did the intern attend class? _________

2. Did the intern show a willingness to work and act in a helpful manner? Y N

3. Please evaluate the performance of the intern:

Strengths:

Areas needing further work:

4. Please make any general comments about the student’s performance:

5. Any additional evaluation material may be attached if appropriate.

Supervising teacher signature:

Date: