Date

Student Name

Student Id

Course Name

Course Number

Instructor

Site Name

Site address

City/State/Zip

Supervisor/evaluator:

Evaluator Email

×

Status message

Please rate the student in the following areas.
1 is Poor and 5 is Outstanding:

Dependability

1

2

3

4

5

Rate between 1 - 5 on Dependability

Attendance

1

2

3

4

5

Rate between 1 - 5 on Attendance

Participation

1

2

3

4

5

Rate between 1 - 5 on Participation

Punctuality

1

2

3

4

5

Rate between 1 - 5 on Punctuality

Overall performance

1

2

3

4

5

Rate between 1 - 5 on Overall performance

Comments

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