2. Employer Organization*

   Name of company

3. Student Name*

   (First & Last)

4. Evaluator Name*

   (First & Last)

6. Did the student arrive on time?*

   1. Yes
   2. No
7. Did the student show interest in the job during the shadowing experience?*

   1. Yes
   2. No
8. Did the student conduct themselves in a professional manner?*

   1. Yes
   2. No
10. Did the student ask appropriate questions?*

    1. Yes
    2. No
11. Did the student demonstrate skills that would indicate that they may be ready for an entry-level internship at your place of employment?*

    1. Yes
    2. No
13. Feedback

    Please use the space above to give positive feedback as well as suggestions to help this student maximize potential future opportunities.

15. Thank you for your partnership in the work-based learning program!
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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

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