Student Name__________________________________________ M Number_____________________________

MSU Advisor___________________________________________Co-op Course___________________________

Current Address________________________________________Email__________________________________

Employer Name_________________________________________Phone__________________________________

Co-op Supervisor________________________________________Title___________________________________

Student Title___________________________________________Work Term______________________________

General description of the type of work done during the co-op assignment.
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List the major duties performed on the job in descending order of complexity and importance.

1.__________________________________________________________________________________________
2.__________________________________________________________________________________________
3.__________________________________________________________________________________________
4.__________________________________________________________________________________________
5.__________________________________________________________________________________________

In what ways have your duties changed from beginning to end or from past work assignments?
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Explain how your work assignment is related to your academic major and what you learned.
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PERFORMANCE RATING

For the purpose of counseling, the following section is designed to let you, the student, evaluate yourself on your current assignment. 
In doing so, you will be able to identify those aspects of your performance and work habits that are in need of improvement as well as
those which can be considered assets to your professional growth.
                                                                                                          Above                                  Below
                                                                                     Excellent    Average    Satisfactory    Average    Unsatisfactory
Volume of work produced                                          5________4_______3_________2________1__________n/a_____
Quality of work produced                                          5________4_______3_________2________1__________n/a_____
Effectiveness in preparing/organizing work            5________4_______3_________2________1__________n/a_____
Ability to accept interruptions                                  5________4_______3_________2________1__________n/a_____
Keep constructively busy & mentally alert              5________4_______3_________2________1__________n/a_____
Ability to adjust to organization's policies               5________4_______3_________2________1__________n/a_____
Effectiveness in communication skills                      5________4_______3_________2________1__________n/a_____
Working relationships with others                          5________4_______3_________2________1__________n/a_____
Ability to apply academic training to job                5________4_______3_________2________1__________n/a_____
Relationship of work to career goals                       5________4_______3_________2________1__________n/a_____
Effectiveness of training/supervision on job           5________4_______3_________2________1__________n/a_____
Overall rating of  performance                                5________4_______3_________2________1__________n/a_____

What do you think you could do to improve your performance and contributions to your overall professional growth?
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POSITION APPRAISAL

List the major aspects of your current assignment which you feel are most beneficial to your professional development.
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If you have any recommendations which you feel would increase the value of this assignment, please list below.
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Do you plan to co-op with this employer again in the future?                   ________Yes    __________No
If no, will you seek another co-op assignment prior to graduation?       ________Yes    __________No
Have you conpleted the assignments required by the department?         ________Yes   __________No
(If you are unsure about the department requirements, please contact Career Services at 809-3117 or email brooke.wiles@murraystate.edu)

Signature____________________________________________________________Date_______________________