This form is to be completed by the employer. By clicking on the submit button at the end of the form, it will be electronically sent to the program coordinator.  Complete this form by filling in the required blanks and clicking on the "Submit" button at the bottom of the page.  Please fill out on an "As-Needed"
basis. (Monthly is suggested).  *This information will be shared with the student unless indicated otherwise!

Student Name:

Employer Name:

Employer Email:

Report Date:

Intern's Field of Study:

 

Briefly describe the intern's work performance as of this date. (Please list both positive and negative characteristics)

 

Please list any suggestions for improvement for this intern. 

 

Any other comments would be appreciated. 

 

Do you wish to be contacted by the program coordinator?