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0 % % % % % % % % % : FORM IX
Students Midterm Evaluation of Internship
Form IX is to be completed (typed) by the student intern after the fifth week of internship (MS Word version with embedded text boxes that expand automatically to accommodate responses is available at HYPERLINK "http://www.wiu.edu/leja" www.wiu.edu/leja). The intern should e-mail the completed form (MS Word file attachment, which should be named as last name first name fl/sp/sum year) via her/his ϲʷ¼ e-mail address to HYPERLINK "mailto:leja-internship@wiu.edu" leja-internship@wiu.edu; the senders ϲʷ¼ e-mail address represents a signature. The completed form may also be mailed to Internship Coordinator, ϲʷ¼ - LEJA, 1 University Circle, Macomb, IL 61455 or faxed to 309/298-2516.
Students Name: Date:
Internship Agency:
Briefly summarize to date your experience in relationship to your goals and the goals of the University.
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Is this experience what you expected? Explain.
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Is this experience helping you accomplish your expected goals?
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4. Is the supervision that you are getting from the agency and university adequate? Explain.
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How can the internship experience be more meaningful?
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What can you do to make your experience more meaningful?
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What can the agency or university do to make your experience more meaningful?
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What experience would you like to see be given more emphasis during the remainder of your time with the agency?
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Note: The intern is recommended to have candid discussions with the Agency Coordinator, or supervisor, regularly to maximize the internship experience. Also, discussing your reactions expressed on this form is helpful for you to make your experience more meaningful.
(Students Signature) (Date)
(Students ϲʷ¼ E-Mail Address)
Page PAGE 2 of NUMPAGES 2
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