
STUDENT INFORMATION
Name:
Agency:
Supervisor:
Supervisor's e-mail:

OVERALL ASSESSMENT OF INTERNSHIP
	Above Expected Level	Expected Level	Below Expected Level
Your overall satisfaction
Major
Relevance to your major
Useful to future career planning
Availability of opportunities to develop skills

ASSESSMENT OF SUPERVISOR
Quality of supervisor
Agency policy procedure
Assigning appropriate tasks
Processing experiences
Relating experiences to major course work
Flexibility and adaptability
BASIC NEEDS
Basic needs met
Space to work
Phone
Computer
SPECIAL CONSIDERATION
Need for a car
Unusual hours
Independent home visits
List personal characteristics that are necessary for a successful experience

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Would you recommend this placement for future students:	Yes No
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Social and Cultural Sciences Majors

Check out our suggested curriculum for our four majors:

• Anthropology
• Criminology and Law Studies
• Social and Welfare Justice
• Sociology