Student Name___________________________________________________Date________________________

Employer Name__________________________________________________Phone_______________________

Co-op Supervisor_________________________________________________Title________________________

Work Period____________________________________________________Year________________________
                            (Spring, Summer, Fall)

Students Title____________________________________________________Total No. Hours Worked_______

WORK PERFORMANCE
                                                                                  Above                                  Below
                                                             Excellent    Average    Satisfactory    Average    Unsatisfactory
Attendance & punctuality                5____        4____        3_____            2____            1____
Preparation for the job (technical)  5____        4____        3_____            2____            1____
Quality of  work (accuracy)             5____        4____        3_____            2____            1____
Quantity of  work (speed)                 5____        4____        3_____            2____           1____
Time management                             5____        4____        3_____            2____            1____
Use of supplies & equipment            5____        4____        3_____            2____           1____
Overall rating of performance         5____        4____        3_____            2____           1____

Comments on work performance:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
 

What work habits/skills/abilities are in need of improvement for this student?
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
 
 

EMPLOYABILITY
                                                                                    Above                                  Below
                                                               Excellent    Average    Satisfactory    Average    Unsatisfactory
Willingness to work                               5_____       4_____      3______         2______         1______
Reaction/response to supervision         5_____        4_____     3_____         2______          1______
Relation/cooperation with co-workers 5____        4____        3_____            2______         1______
Relation with clients                              5_____        4_____    3_____            2_____            1______
Understanding/adherence to rules       5_____        4_____    3_____            2_____            1______
Ability to apply education to job          5_____        4_____    3_____            2_____            1______

What are the most desirable work qualities of this student?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

What are the areas in need of improvement?
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
 

WORK QUALITIES
                                                                                    Above                                  Below
                                                               Excellent   Average  Satisfactory    Average    Unsatisfactory
Writes clearly & effectively              5_____    4_____    3_______        2______        1________
Speaks clearly & effectively              5_____    4_____    3_______        2______        1________
Thinks critically and analytically     5_____    4_____    3_______        2______        1________
Solves complex real-world problems5_____    4_____    3_______        2______        1________
Works effectively with others           5_____    4_____    3_______        2______        1________
Learns effectively on his(her) own   5_____    4_____    3_______        2______        1________
Uses computing/information
    technology effectively                    5_____    4_____    3______           2______        1_______

Comments on work qualities:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
 

PERSONAL QUALITIES
                                                                          Above                                  Below
                                                                    Excellent    Average    Satisfactory    Average    Unsatisfactory
Accepts responsibility/leadership            5______    4______    3_______    2______    1_______
Adaptability (fits in)                                 5______    4______    3_______    2______    1_______
Appearance (appropriate to work)         5______    4______    3_______    2______    1_______
Attitude (enthusiastic about work)         5______    4______    3_______    2______    1_______
Dependability                                           5______     4______    3_______    2______    1_______
Initiative (self-motivated)                        5______    4______    3_______    2______    1_______
Judgment                                                  5______    4______    3_______    2______    1_______

Comments on Personal Qualities:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

General Comments:
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

Would you consider hiring this student full-time if an opportunity arises?     ________Yes    __________No
Has this evaluation been discussed with the student?                                         ________Yes    __________No

Signature____________________________________________________________Date_______________________

The Career Services Office is dedicated to providing students with "real world" experience prior to graduation through the
Cooperative Education Program.  To continue your involvement with this program, contact Brooke Wiles in
Career Services at (270) 809-3117.
 

Final Evaluation_____________________Date of this report___________________________________
                                    (Pass or Fail)

Advisor Signature_____________________________________________________________________

Comments:___________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________