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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)
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| Student Name |
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Employer Name |
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| Job Title |
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Start Date |
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End Date |
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| Semester |
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Hours per week |
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Position Description |
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Salary |
(individual salaries will be kept
confidential; all salary information is reported in aggregate form) |
| Supervisor's Name |
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| Supervisor's Phone |
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| Supervisor's Email |
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| Supervisor's Title |
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| Continuing in this
position for next semester? |
Yes No |
| Are
you getting course credit
for this intern/coop? |
Yes No |
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Please select the next semester that you are seeking an intern/coop
position. |
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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.
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EDUCATIONAL VALUE |
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RELEVANCE TO ACADEMIC
MAJOR/CAREER |
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SALARY
(Based on experience and
academic level) |
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WORK ENVIRONMENT |
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INTERPERSONAL
ENVIRONMENT |
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ATTITUDE, AVAILABILITY OF
SUPERIORS |
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MY PERSONAL ATTITUDE |
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RELATIONSHIPS WITH SUPERVISORS/
COWORKERS |
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TECHNICAL SKILLS |
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