Work Report for Undergraduate Students.
Please complete the form below and submit a completed copy of the
Performance Appraisal from your supervisor (click to view)
to Jerry Alexander in the Industrial Practice Programs Office
.
(Not for use with reports related to courses for credit)

Student Name
Employer Name
Job Title
Start Date
End Date
Semester
Hours per week
Position Description
Salary   (individual salaries will be kept confidential; all salary information is reported in aggregate form)
Supervisor's Name
Supervisor's Phone
Supervisor's Email
Supervisor's Title
Continuing in this position for next semester? Yes No
Are you getting course credit for this intern/coop? Yes No
Please select the next semester that you are seeking an intern/coop position.
It is very important that you evaluate your intern/coop experience-including both positive and negative impressions.  Your responses will be regarded as confidential and will help us determine whether changes need to be made for subsequent IPP work assignments.

EDUCATIONAL VALUE

RELEVANCE TO ACADEMIC MAJOR/CAREER

SALARY (Based on experience and academic level)

WORK ENVIRONMENT

INTERPERSONAL ENVIRONMENT

ATTITUDE, AVAILABILITY OF SUPERIORS

MY PERSONAL ATTITUDE

RELATIONSHIPS WITH SUPERVISORS/
COWORKERS

TECHNICAL SKILLS