Introduction by I0FVNFi

VIEWS: 4 PAGES: 16

									       Directions, Contract,
Self-assessments and Evaluations




                                                         Advising Center

                          275 North Syndicate, St. Paul, Minnesota 55104-5494
                       Phone: 651/641-8708 or 651-603-6241 FAX: 651/659-0207
 Home page: http://concordia.csp.edu/AcademicAdvising/Index.html




                    1
                                                 Table of Contents

Introduction, General Objectives - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 3


Fees - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 3


Registration - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 3


Credit, Grading, and Evaluation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 4


What the Student should know - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 4


What the Academic Advisor/Supervisor should know - - - - - - - - - - - - - - - - - Page 4


How does the Advising Center help? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -                      Page 5


Sample Contract and Supplement - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 6 & 7


Internship Contract - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 8


Self-Assessment for Growth Form - - - - - - - - - - - - - - - - - - - - - - - Page 10


Monthly Activity Logs - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 11 & 12


Final Evaluation by Intern - - - - - - - - - - - - - - - - - - - - - - - - - - - - Page 13 & 14

ON-SITE SUPERVISOR SECTION (to be given to the Supervisor) - - - - - - - - - - Page 15& 16

         Please note: The Internship Manual is available on the Academic Advising Web Page.

                             http://concordia.csp.edu/AcademicAdvising/Index.html




                                                                2
Introduction                                                  4.   The number of credits to be earned, not to exceed
An internship is a planned and supervised field-                   more than 12 credits.
based educational experience. It is the practical             5. A brief description of the activities, expectations,
                                                                   and responsibilities obtained from organizational
application of theoretical principles.
                                                                   brochures and follow-up interviews.
                                                              6. Specific objectives agreed upon by the intern, an
Internships serve as a step in the career                          organizational representative, and the academic
development process and may be approached in                       advisor.
the same way as part of a professional job search.            7. An outline of specific strategies or responsibilities
Interns who successfully complete an internship,                   which will include on-site and off-site activities to
are desirable candidates for job opportunities.                    demonstrate how the objective will be met.
                                                              8. A statement of the number of clock hours for on-
The field experience includes actual work, observation             and off-site activities to demonstrate how the
or both. The intern receives college credit for the                objectives will be met. Thirty-five (35) clock
field-based work. The number of credits earned is                  hours constitutes one (1) credit.
determined by the academic advisor and the student            9. Relationship of activities to objectives.
intern. For each one (1) internship credit, the               10. Two methods of evaluation
student is required to document 35 hours of                        a. Formative evidence of learning;
work on the job.                                                   b. Summative evidence which results in a
                                                                         pass/no pass grade at the end of the
General Objectives                                                       internship.
                                                              The supervision for the evaluation will be done by the
Guidelines and objectives for all business and
                                                              on-site and academic advisor/supervisors. The
liberal arts internships are arranged through                 academic advisor/supervisor will visit the internship
Concordia University. Interns will                            site at least once if possible, or expect the student-
    Integrate knowledge and theory with field                intern to call at mid-term to talk about the internship.
     experience.
    Evaluate vocational options based on newly               Fees
     acquired knowledge and skills.                           The student pays the regular educational fees
    Observe professionals in the field to benefit from       during the internship. The student arranges
     their experience and expertise.
                                                              transportation. Internships in the College of Arts
    Complete work assignments successfully.
                                                              and Sciences are approved within a fifty-mile
    Develop basic skills required for employment.
                                                              radius of the college unless the student makes
    Strengthen interpersonal and communication
     skills.                                                  provisions for supervision outside this radius.
    Select courses to supplement the internship
     experience.                                              Registration
    Develop a positive and self-confident attitude           The student is required to complete all of the
     prior to entering the world of work.                     paperwork for an internship three weeks prior to
                                                              the term in which the internship starts. Follow
Specific internship objectives will be developed by the       these steps:
student/intern and academic advisor/supervisor.               1.   Make initial arrangements with the organization
                                                                   and academic advisor eight to ten weeks prior to
The Internship Contract                                            the semester that the internship begins.
The internship contract is a written agreement                2.   Arrange contractual details of the internship with
involving the student, the organization, and                       the organization, the on-site supervisor, and the
Concordia University. It shall include                             academic advisor.
1.   The intern’s and organization’s information.             3.   Obtain appropriate signatures and secure final
2.   Signatures of the student, the academic advisor/              approval from the director of student academic
     supervisor, department chair, the director of                 advising.
     student academic advising, and the registrar.            4.   Submit five (5) copies of the contract to the
3.   The semester, the academic year, the beginning                registrar who will distribute copies to the
     and ending dates. Internships may extend more                 appropriate offices.
     than one semester.



                                                          3
This will constitute and complete the registration
process.


Credit and Grading
Students are responsible for determining the               The Student
number of credits they plan to earn for an                 1.  Receives information from the CAP Center or
internship. This is decided in consultation with               companies on an individual basis.
                                                           2. Assesses personal interests and aptitude to
the academic advisor, on-site supervisor, or an
                                                               facilitate appropriate internship selection.
academic supervisor from the department in                 3. Meets with academic advisor to explore internship
which credit will be applied. Grades are assigned              possibilities.
by the academic supervisor when evaluation                 4. Designs his/her own internship by researching
forms are completed. Extension for incomplete                  areas of interest, interviewing employers and
work must be approved in writing and submitted                 discussing possibilities with academic supervisor.
to the academic supervisor.                                5. Visits site prior to internship to observe and to
                                                               meet the co-workers to determine whether the
Evaluation and Policy Procedures                               internship will be a good “fit.”
Internships are evaluated by the student, on-site          6. Meets with the academic advisor/supervisor to
                                                               write up the internship contract and informs the
supervisor, and academic advisor/supervisor.
                                                               on-site supervisor of the plans and the starting
                                                               date.
Based on observations, the on-site supervisor              7. Completes contract and supplement.
submits a mid-term and final evaluation form to            8. Makes five initial copies and one additional copy
the Career, Advising and Planning (CAP) Center.                after all the signatures have been acquired. Sends
Interns fill in two (2) monthly "Activity Logs"                one copy to the field supervisor. The other copies
and send them to the academic advisor/supervisor               are distributed by the registrar.
during the course of the internship. Written               9. Schedules an on-site or telephone visit with the
progress reports may also be used if specified in              academic advisor/supervisor at mid-term.
the contract.                                              10. Submits evaluation forms to academic supervisor
                                                               at one and two month intervals and at the end of
                                                               semester.
Students complete a "Self-Assessment For
Growth" at the beginning of the internship and             The Academic Advisor/Supervisor
again at the end of the internship. They will also         1.   Is chosen from the department where interests and
fill out a final evaluation form. The information               academic requirements match the internship
on these forms is used for assessment purposes of               assignment.
both the student and the internship site.                  2.   Integrates the internship into the total academic
                                                                experience by helping the student to develop
The academic advisor/supervisor is responsible                  sound objectives and goals.
for the final evaluation and grade. The final              3.   Approves internships and signs the contracts.
evaluation is filed with the academic supervisor           4.   Serves as a resource person who arranges
                                                                meetings, assists with problem solving, and acts as
and a copy made for the CAP Center. Several
                                                                a sounding board for new ideas and insights.
methods of evaluation may be used by the                   5.   Visits interns at the internship site some time
academic supervisor for evaluation purposes.                    around mid-term.
These include on-site visits, conferences,                 6.   Evaluates the student’s learning based on the
examinations, journals, or summary papers.                      contract.
Journals not only include daily entries of                 7.   Submits final evaluation to the director of student
experiences, events, and critical analysis, but also            academic advising.
may illustrate how theories are integrated with            8.   Submits a final grade to the office of the registrar.
practical applications.




                                                       4
                                                               8.   Interface with academic departments.




The Career, Advising and Planning (CAP)
Center                                                         Recommended for all
Concordia’s internship program is coordinated
through the Career, Advising and Planning (CAP)
                                                               internships:
Center. The CAP Center will                                    KEEP A JOURNAL
1.   Provide information on possible internship sites to       To get the most out of an internship, keep a log of what
     interns, faculty and supervisors.                         gets done and what was learned. At the end of each
2.   Assist students in goal setting, decision making,         work period, summarize all experiences, focusing as
     writing resumes and cover letters, and preparing          much on what was learned as well as what was done!
     for interviews.                                           Be sure to save copies of everything. Each log entry
3.   Keep up to date information on resources for              should include
     internships in the CAP Center.                             What was done
4.   Help students find available resources for possible        What was learned
     internship sites.                                          What was accomplished
5.   Ensure implementation of procedures consistent
                                                                Who was met and how they can be reached.
     with faculty policies.
                                                               This journal will be a valuable resource when you are
6.   Help keep faculty and staff appraised of the
                                                               developing a resume, preparing for interviews, or
     internship policies and procedures.
                                                               networking. It may also be one method of evaluation.
7.   Search for new local and global internship
     resources among business, industry, alumni,
     government, and non-profit organizations.




                                                           5
                                                                                                  Sample
                                           INTERNSHIP CONTRACT

Student: Sue College Student_________ Student ID# L_00000000____________________
Class Status:     Freshman     Sophomore      Junior   Senior   Other ___________________

Major(s): Psychology                                                Minor: ____________________________

Academic Advisor: Dr. Bredehoft___________________________

University Internship Supervisor (Internship Course Instructor): Dr. Bredehoft_________________________

On-site Internship Supervisor: Mr. Bob Dow___________________ Phone: _651-298-0000_____________

Name of organization where internship will be: Fall County Correction Facility
                                           th
Address of organization: 0000 West 0 Street                  Fall City,       MN                       00000
                                       Street                     City           State                Zip
Title of the internship position you will be holding: Juvenile Detention Worker Intern

What is the nature of the internship? Rehabilitation of Juvenile Law Violators

Semester Internship Is Registered For: Fall ____x__ (year) Spring_______ (year) Summer ______ (year)

Course Number: ___Psy 498________ Course Title: Psychology Intern__________________________

Number of Credits: __12________ Dates of Internship, From _8/15/2006___ To___12/22/06_________

Number of internship hours per week: ____25___ TOTAL internship hours for the whole semester: ____420_______
Contract Guidelines: All parties to this contract shall follow the Internship Manual guidelines. A Contract Supplement
must be attached and contain the following five parts:

1.   A brief description of the internship.
2.   A list of specific objectives for what you will do and what you will learn.
3.   Strategies or activities for achieving those objectives, with expected number of hours for each activity
4.   Relationship of activities to objectives.
5.   Two evaluation methods. (See samples in the Internship Manual)

At least three weeks before the internship begins, after all signatures have been obtained, submit the original contract
and supplement to the Registrar. The registrar will register the internship and return via campus mail the signed copies
to each signatory and two copies to the student. Then the student will take one copy to their on-site supervisor.

                                                                              Date:
Student Signature

                                                                              Date:
Academic Advisor/University Supervisor Signature

                                                                              Date:
Academic Department Chair Signature

_______________________________________________________ Date: ________________________
Dean of College Signature

                                                                              Date:
Registrar Signature


                                                            6
                                                  CONTRACT SUPPLEMENT:

Psy-461 Psychology Internship                                           A. On-site activities                           Hours per week
                                                                          1. Search the children and their rooms for contraband. 2
Name: Sue College Student 651/641-8200                                    2. Protect children from their own actions.                 2
Site: Ramsey County Juvenile Detention Center                             3. Learn interpersonal and crisis counseling.               3
Address: 480 St. Peter Street                                             4. Write behavior observation reports.                      5
          St. Paul, MN 55102                                              5. Ensure the children are in their scheduled daily
Telephone: 651/298-6930                                                      activities.                                              1
ON-site Supervisor:         Dick Loesch                                   6. Assist in or provide leadership for activities (mealtime,
Academic Supervisor: Dr. David Bredehoft                                     daily cleaning tasks, school programming, gym
                                                                             activities, and leisure time recreating activities).   20
I.      Brief Description of the Internship (50-75 words)                 7. Ride along with a police squad.                          1
                                                                          8. Observe in court.                                        1
I will be participating in an internship fall quarter 1987, at
the Ramsey County Juvenile Detention Center. This                       B. Off-site activities
internship will begin September 18 and end November 25.                   9.       Keep a daily journal.                           5
                                                                          10.      Interview a lawyer, juvenile judge.
Juvenile detention is the juvenile justice system’s most                  11.      Read orientation booklet, JDC policy manual,
physically restricting and controlling alternative. It provides           12. JDC security policies and guidelines, general rules
temporary behavioral control that children are either                             for residents.                                   1
unwilling or unable to exert over their own behavior.                     13. Write a 10-12 page summary paper reflecting on
Placement in juvenile detention is temporary. Every child                      experiences during internship.                      3
there is awaiting some pending action, such as release to                 14. Write a 1-2 page paper summarizing experience with
parents, return to other placement, initial court hearing, trial,              police squad.                                       1
deposition, court-ordered placement, or certification to adult            15. Watch videos on juvenile arrest, search, principles of
court.                                                                         discipline, legal rights, physical restrain, AIDS.  1

The responsibility of juvenile detention within this context is              Combined Total Hours per week = 45 hours
to provide the following: safety for self and others, security,              Total Hours over the course of the Internship =
positive interactions with authority figures who care about                  45 hrs/wk X 15 weeks = 675 hours.
people, support and coordination with others beyond
detention (court, probation officers, families, schools, etc.),         IV.         Relationship of Activities to Objectives
and encouragement and basic counseling with residents                                 Objective(s)                        Activities
toward recognizing their problems and being willing to use                                 A ............................ 3, 5, 6, 9, 12
help from others within the system as they leave detention.                                B ............................ 10, 11, 14
                                                                                           C ............................ 7, 8, 10, 13, 14
II.     Specific Objective                                                                 D ............................ 6
                                                                                           E ............................ 2, 3, 11
The student will:                                                                          F............................. 2, 5, 6
A. Gain experience working with troubled adolescents.                                      G ............................ 1, 2, 10, 14
B. Learn about the role of juvenile detention within the                                   H ............................ 3, 4, 6, 9, 12, 13
     juvenile justice system and its basic philosophy.
C. Gain a greater understanding of the criminal justice                 V.       Evaluation
     system from various perspectives.                                         A.  Evidence of Learning
D. Develop group leadership skills.                                                1. The on-site supervisor will evaluate on site
E. Develop an effective approach for working with young                                 performance.
     people.                                                                       2. The academic supervisor will evaluate the
F. Learn skills to become an effective team member.                                     student following an on-site visit.
G. Learn basic procedures for safety and security.                                 3. The student will evaluate self-progress at
H. Develop communication skills                                                         periodic intervals throughout the internship.
                                                                               B. Method of Grading
                                                                                   The students will be evaluated on a pass/no pass
                                                                                   basis.
III.    Outline of specific Strategies or Responsibilities




                                                                    7
                                              INTERNSHIP CONTRACT

Student:                                                  ___________ Student ID# L_________________________

Class Status:         Freshman         Sophomore         Junior      Senior      Other ___________________________

Major(s):                                                                     Minor: ____________________________

Academic Advisor: _______________________________________

University Internship Supervisor (Internship Course Instructor): ______________________________________

On-site Internship Supervisor: _______________________________ Phone: ___________________________

Name of organization where internship will be:

Address of organization:
                                          Street                     City               State          Zip

Title of the internship position you will be holding:

What is the nature of the internship?

Semester Internship Is Registered For: Fall ________ (year) Spring_______ (year) Summer ______ (year)

Course Number: ______________ Course Title:                        ___________________________________________

Number of Credits: ____________ Dates of Internship, From _________________ To_________________

Number of internship hours per week: __________ TOTAL internship hours for the whole semester: _____________
Contract Guidelines: All parties to this contract shall follow the Internship Manual guidelines. A Contract Supplement must
be attached and contain the following five parts:

6.    A brief description of the internship.
7.    A list of specific objectives for what you will do and what you will learn.
8.    Strategies or activities for achieving those objectives, with expected number of hours for each activity
9.    Relationship of activities to objectives.
10.   Two evaluation methods. (See samples in the Internship Manual)

At least three weeks before the internship begins, after all signatures have been obtained, submit the original contract and
supplement to the Registrar. The registrar will register the internship and return via campus mail the signed copies to each
signatory and two copies to the student. Then the student will take one copy to their on-site supervisor.

                                                                               Date:
Student Signature

                                                                               Date:
Academic Advisor/University Supervisor Signature

                                                                               Date:
Academic Department Chair Signature

_______________________________________________________ Date: ________________________
Dean of College Signature

                                                                             Date:
Registrar Signature                                                See page 2 for whom to contact for signatures.

                                                               8
Deans
Dean of College of Arts and Sciences              Dr. Alan Winegarden
Undergraduate Academic Associate Dean of College  Dr. Bruce Corrie
of Business and Organizational Leadership
Dean of College of Education                      Prof. Lonn Maly
Dean of College of Vocation and Ministry          Dr. Steve Arnold
Academic Department Chairs, Arts and Sciences
Art                                               Prof. Keith Williams
Biology                                           Dr. Amy Gort
Communication Studies                             Dr. Marilyn Reineck (Dr. Lori Charron for fall 2006)
English and Modern Languages                      Dr. Debra Beilke
History                                           Dr. Paul Hillmer
Mathematics                                       Dr. Rob Krueger
Music                                             Dr. David Mennicke
Physical Sciences                                 Dr. Dale Trapp
Social and Behavioral Sciences                    Dr. David Bredehoft
Theatre                                           Prof. Michael Charron
Academic Department Chairs, Business and Organizational Leadership
Business, BBA Program Chair                       Dr. Bruce Corrie
Academic Department Chairs, Education
Child and Family Education                        Dr. Lynn Gehrke
Kinesiology & Health Sciences                     Dr. Eric LaMott
Teacher Education
Academic Department Chairs, Vocation and Ministry
Church Ministries                                 Dr. Stephen Stohlmann
Religion and Theology                             Dr. David Lumpp
Institute for Faith and Life                      Dr. Steve Arnold
Registrar
Ms. Jody Ragan, BEAR Center




                                                    9
    SELF-ASSESSMENT For GROWTH                                 Date: ____________
    Intern Name_______________________ Academic Supervisor_____________________
    Please evaluate your own skills and abilities at this point in your academic career using the following 5 point
    scale. Keep in mind that the learning process is on-going and that it is probably not realistic to expect mastery
    of most of these skills. Your honest self-assessment will help you evaluate your growth as you go through your
    internship. It will also provide information that will help you plan for additional educational needs. This self-
    assessment is to be done at the beginning of the internship and again at the completion of the internship.

        Scale:      1. Not important or relevant to me at this time 2. I don't feel I have this skill/ability
                    3. I feel I have some or fair skill/ability in this area, but I will need to ask for help.
                    4. I am confident that I have enough or good skill/ability to do this with very little assistance.
                    5. I am confident that I can effectively use my skills/abilities in an excellent manner.

                                                        Beginning           End of           Comments:
        I feel that I have the                          of semester         semester
                                                         Score              Score
1       Preparation for this internship.
2       Writing skills needed.
3       Ability to work independently.
4       Ability to listen and speak so others
        understand me.
5       Thoroughness and attention to
        detail needed.
6       Ability to attain others' trust and
        confidence.
7       Ability to handle duties responsibly.
8       Ability to demonstrate creativity.
9       Ability to complete work on time.
10      Professional attitude needed.
11      Adaptability needed for this
        internship.
12      Ability to cooperate with others.
13      Work attendance/punctuality
        expected.
14      Courteous attitude at all times.
15      Professional appearance, neat, well-
        groomed.
16      Ability to evaluate strengths and
        weaknesses and apply appropriate
        changes.
17      Ability to relate to others in a
        meaningful way.
18      The knowledge that satisfaction
        comes from a job well done and is
        not dependent on outside feedback.

    Upon completion of your internship, this should be handed in to your academic supervisor /advisor.

    Student Signature: __________________________________________________
    Date:____________________



                                                                     10
                                             FIRST MONTH ACTIVITY LOG

Intern:_____________________________                                                               Date _________

ON-SITE Supervisor _____________________________ at ____________________
                                                                                          Company Name

This information is invaluable in evaluating your internship site. Please complete this and hand it in or e-mail it to your
academic supervisor (advisor) after your first month.
Step 1: In the boxes on the left, note the percent of time spent in these 4 major areas
Step 2: Within each of the major categories, break down the percent of time spent in each type of activity. Note this in the
         boxes on the right.
Please note: The percentage within the left most column and within each category and the overall percentages listed
        should total 100%.

    %    Percent of time working directly with Supervisor

         Percent of time observing only                                                                                  %
         Percent of time interacting with Supervisor                                                                     %
         Percent of time interacting with others in the department                                                       %
         Percent of time interacting with outsiders (clients, other organizations, etc)                                  %
                                                                                                                    = 100%

    %    Percent of time working with other administrative personnel or other staff

         Percent of time observing only                                                                                  %
         Percent of time interacting with others in department pertaining to my job                                      %
         Percent of time doing off site activities                                                                       %
         Percent of time doing "busy work" not related to internship                                                     %
                                                                                                                    = 100%

    %    Percent of time working on activities related to your objectives/goals

         List Objective/goal 1                                                                                           %
         List Objective/goal 2                                                                                           %
         List Objective/goal 3                                                                                           %
         List Objective/goal 4                                                                                           %
         List Objective/goal 5                                                                                           %
                                                                                                                    = 100%

    %    Percent of time working on your own/self-directed activities

         List Duty 1                                                                                                     %
         List Duty 2                                                                                                     %
         List Duty 3                                                                                                     %
         List Duty 4                                                                                                     %
         List Duty 5                                                                                                     %
=100%                                                                                                               = 100%

         How many times have you called/met/e-mailed your academic advisor?



*Turn this sheet in to your Academic Advisor ___________________ upon completion.
                                                      Name

                                                              11
                                    SECOND MONTH ACTIVITY LOG

Intern:_____________________________                                                               Date _________

ON- SITE Supervisor _____________________________ at ____________________
                                                                                          Company Name

This information is invaluable in evaluating your internship site. Please complete this and hand it in or e-mail it to your
academic supervisor (advisor) after your first month.
Step 1: In the boxes on the left, note the percent of time spent in these 5 major areas
Step 2: Within each of the major categories, break down the percent of time spent in each type of activity. Note this in the
         boxes on the right.
Please note: The percentage within the left most column and within each category and the overall percentages listed
        should total 100%.

    %    Percent of time working directly with Supervisor

         Percent of time observing only                                                                                  %
         Percent of time interacting with Supervisor                                                                     %
         Percent of time interacting with others in the department                                                       %
         Percent of time interacting with outsiders (clients, other organizations, etc)                                  %
                                                                                                                    = 100%

    %    Percent of time working with other administrative staff

         Percent of time observing only                                                                                  %
         Percent of time interacting with others in department                                                           %
         Percent of time doing Off-site activities                                                                       %
         Percent of time doing unrelated "busy work"                                                                     %
                                                                                                                    = 100%

    %    Percent of time working on activities related to your objectives

         List Objective/goal 1                                                                                           %
         List Objective/goal 2                                                                                           %
         List Objective/goal 3                                                                                           %
         List Objective/goal 4                                                                                           %
         List Objective/goal 5                                                                                           %
                                                                                                                    = 100%

    %    Percent of time working on your own/self directed activities

         List Duty 1                                                                                                     %
         List Duty 2                                                                                                     %
         List Duty 3                                                                                                     %
         List Duty 4                                                                                                     %
         List Duty 5                                                                                                     %
=100%                                                                                                               = 100%

         How many times have you called/met/e-mailed your academic advisor?


*Turn this sheet in to your Academic Advisor ___________________upon completion.
                                                      Name

                                                              12
                                                  Final Evaluation by Intern
*Note: Please finish your Self Assessment (page 8) and attach that to this Evaluation. Then send both to your Academic
Advisor/Supervisor.
Please make one copy to give to the CAP Center to evaluate how well this internship met your goals/objectives.

Intern’s Name:                                                          Date:                           Class:

Academic Advisor/Supervisor:                                                      Credits awarded:

On-Site Supervisor:

Organization:                                                    Address:

Directions: At least three days before the end of the internship schedule an appointment with your academic advisor/supervisor and
submit this form at the end of your schedule appointment. You must keep your academic advisor/supervisor informed, otherwise, you
risk getting an NP grade for your internship.

GOALS:
                                                                                  Strongly     Agree             Disagree   Strongly
                                                                                  Agree                                     Disagree

1.   It was easy to define field experience goals with the field supervisor.
2.   I readily understood fieldwork assignments.
3.   I felt I was given sufficient responsibility in my fieldwork.
4.   Fieldwork assignments were directly related to the organization’s purpose.
5.   I derived a great deal of satisfaction from the work assignments.

6.   List the most important assignments and explain why they were significant.



7.   List the least important assignments and explain why you felt they were or were not significant.



Personal Goals

8.   Indicate your personal goals and explain how this internship helped you accomplish them.




9.   How did your academic and field supervisors help you maintain your personal goals?



________________________________________________________________________________________________________


10. What are your career goals now that you have finished this internship?



________________________________________________________________________________________________________


11. How did this internship affect your career plans?



________________________________________________________________________________________________________



                                                                   13
Academic Supervision
How many times did you meet with your academic supervisor for preparation of your internship:

                     Hrs/before                           Hrs/during                  Hrs/after the internship

Was the frequency of meetings adequate?                   Yes               No
Explain:



Suggest relevant activities for future internships.



On-Site Supervision
                                                                       Always              Usually               Seldom
Guidance from the field supervisor was available to me.
Instructions and comments were understandable to me.
Responsibility was delegated to me.

I would recommend this internship to others. Yes___ No___ Why or why not?


________________________________________________________________________________________________________
________________________________________________________________________________________________________


Personal Assessment: Please complete your "Assessment for Growth Form" (page 8) and attach to this form.

Summary

Your comments regarding the internship experience are very important to your advisor and to the internship
office. Please share your opinions, suggestions, constructive criticisms, and positive remarks for future
reference.




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______________________________________________________________________________________
______________________________________________________________________________________


What was the value of this internship to you?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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Would you be willing to let us use any of the above information as a quote or write a brief article to be
published on or off campus regarding the value of internships?
                 Yes             No


Student signature: __________________________________________________________________________________________



                                                                   14
On-Site Supervisor Section

                           Mid-Term Evaluation by On-Site Supervisor
To be filled out and mailed to the Academic Advisor/Supervisor (named below) at: Concordia University 275 N. Syndicate, St.
Paul, MN 55104-5494

Intern:                                                                         Date:

Students please note: At the time of this semester evaluation, please call your academic advisor/supervisor and schedule an appointment.

Field Supervisor:                                                       Academic Supervisor:

Organization:

Address:

Field Supervisor Directions: Please complete this evaluation form at mid-semester (7 weeks into the internship) and mail to the academic
supervisor listed above. Your frank opinions and comments will not only facilitate the assessment of the intern’s performance, but will
also identify problems that need attention.

Please circle the appropriate rating:
                                                                                Low                  Average                High
                                                                                  1         2           3           4          5
The intern named above
1. Came well prepared for this internship                                         1         2            3          4           5
2. Possesses necessary writing skills                                             1         2            3          4           5
3. Possesses necessary speaking skills                                            1         2            3          4           5
4. Works independently                                                            1         2            3          4           5
5. Does assignments thoroughly                                                    1         2            3          4           5
6. Demonstrates responsibility                                                    1         2            3          4           5
7. Is dependable                                                                  1         2            3          4           5
8. Shows creativity                                                               1         2            3          4           5
9. Produces high quality work                                                     1         2            3          4           5
10. Produces maximum quality of work                                              1         2            3          4           5
11. Exhibits a professional attitude                                              1         2            3          4           5
12. Adapts to changing circumstances                                              1         2            3          4           5
13. Cooperates consistently                                                       1         2            3          4           5
14. Maintains regular attendance                                                  1         2            3          4           5
15. Is punctual                                                                   1         2            3          4           5
16. Is courteous and friendly                                                     1         2            3          4           5
17. Presents an acceptable personal appearance                                    1         2            3          4           5
18. Exhibits growth and maturity                                                  1         2            3          4           5

Comments:




On-Site Supervisor Signature:

Work Phone Number:                                                              Date:

                                                                   15
                                  End of Semester Evaluation by ON-Site Supervisor
To be filled out and mailed to the Academic Advisor/Supervisor (listed below) at: Concordia University 275 N. Syndicate, St. Paul,
MN 55104-5494

Intern:                                                                         Date:

Students please note: At the time of this evaluation, please call your academic advisor/supervisor and schedule an appointment. Your
academic advisor/supervisor must hear from you by the end of the semester in order for you to receive a passing grade.

Field Supervisor:                                                       Academic Supervisor:

Organization:                                               Address:

On-Site Supervisor Directions: Please complete this evaluation form at semester’s end (14 weeks or end of the internship) and mail to the
academic supervisor listed above. Your frank opinions and comments will not only facilitate the assessment of the intern’s performance,
but will also identify problems that need attention.

Please circle the appropriate rating:
                                                                                Low                   Average               High
                                                                                  1         2            3           4         5
The intern named above
1. Came well prepared for this internship                                         1         2            3           4          5
2. Possesses necessary writing skills                                             1         2            3           4          5
3. Possesses necessary speaking skills                                            1         2            3           4          5
4. Works independently                                                            1         2            3           4          5
5. Does assignments thoroughly                                                    1         2            3           4          5
6. Demonstrates responsibility                                                    1         2            3           4          5
7. Is dependable                                                                  1         2            3           4          5
8. Shows creativity                                                               1         2            3           4          5
9. Produces high quality work                                                     1         2            3           4          5
10. Produces maximum quality of work                                              1         2            3           4          5
11. Exhibits a professional attitude                                              1         2            3           4          5
12. Adapts to changing circumstances                                              1         2            3           4          5
13. Cooperates consistently                                                       1         2            3           4          5
14. Maintains regular attendance                                                  1         2            3           4          5
15. Is punctual                                                                   1         2            3           4          5
16. Is courteous and friendly                                                     1         2            3           4          5
17. Presents an acceptable personal appearance                                    1         2            3           4          5
18. Exhibits growth and maturity                                                  1         2            3           4          5



Comments:




On-Site Supervisor Signature:

Work Phone Number:                                                              Date:


Academic Advisor/Supervisor Directions: Make ONE (1) copy of this final evaluation to give to the CAP Center to help in
evaluating this internship site. The original should stay in the student’s academic advising folder.


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