Tennessee State University

Cooperative Education & E-Business Program

3500 John A. Merritt Blvd.

Nashville, TN 37209

615/963-7481 (Voice) 615/963-7567 (Fax)

Employer Assessment of Cooperative Education Student

For the student to receive maximum benefit from the work experience and receive an appropriate co-op grade, completion of this form is essential.

Employer:______________________________________________________________

Assignment Location:_____________________________________________________

^(Number) ^(Street)

_______________________________________________________________________

^{(City) (State) (Zip Code)}

Web Address:____________________________________________________________

Department or work unit:___________________________________________________

Current semester employment dates: From_________________ To________________

Please describe the essential function of your work unit: _______________________

_______________________________________________________________________

Please describe the student’s work assignment for the current semester:__________

_______________________________________________________________________

Please assess the student’s work assignment from the following two perspectives:

The above position provides important skill development and learning for anyone majoring in this student’s specific discipline. Please check one choice:

Consistently Most of the Time Frequently Occasionally Never

The above position provides important skill development and learning directly related to this student’s current professional goals, regardless of major field of study. Please check one choice:

Consistently Most of the Time Frequently Occasionally Never Not Discussed

Performance Skills Assessment

Specific comments, examples and observations to support the ratings should be included. The performance skills should be rated using the following scale.

Please check the appropriate box below:

5 Excellent (the best or one of the best in this category)

4 Good (above average, but not excellent)

3 Satisfactory (average when compared to others in this category)

2 Poor (lacking in some important aspects or less than satisfactory)

1 Unsatisfactory (lack of ability, failure to use it or any other cause)

N/A Not applicable or no opportunity to observe

PERFORMANCE SKILLS RATING COMMENTS OBSERVATIONS

(scale)

Communication 5 4 3 2 1 N/A

Speaks with clarity and confidence _______

Writes clearly and concisely _______

Makes effective presentations _______

Exhibits good listening and questioning

skills _______

_______________________________________________________________________________________

Conceptual/ Analytical Ability 5 4 3 2 1 N/A

Evaluates situations effectively _______

Solves problems/makes decisions _______

Demonstrates original and creative

thinking _______

Identifies and suggests new ideas _______

_______________________________________________________________________________________

Learning/Theory and Practice 5 4 3 2 1 N/A

Learns new material quickly _______

Accesses and applies specialized

knowledge _______

Applies classroom learning to

work situations _______

_______________________________________________________________________________________

Professional Qualities 5 4 3 2 1 N/A

Assumes responsibility/accountability

for actions _______

Exhibits self-confidence _______

Possesses honesty/integrity/personal

ethics _______

Shows initiative/ is self motivated _______

Demonstrates a positive attitude towards

change _______

_______________________________________________________________________________________

PERFORMANCE SKILLS RATING COMMENTS OBSERVATIONS

(scale)

Teamwork 5 4 3 2 1 N/A

Works effectively with others _______

Understands and contributes to the

organization’s goals _______

Demonstrates flexibility/adaptability _______

Functions well on multidisciplinary team _______

_________________________________________________________________________________________

Leadership 5 4 3 2 1 N/A

Given direction, guidance and training _______

Motivates others to succeed _______

Manages conflict effectively _______

_________________________________________________________________________________________

Technology 5 4 3 2 1 N/A

Uses technology, tools instruments and

information _______

Understands complex systems and their

interrelationships _______

Understands the technology of the

discipline _______

________________________________________________________________________________________

Work Culture 5 4 3 2 1 N/A

Understands and works within the culture

of the group _______

Respects diversity _______

Recognizes political and social

implications of actions _______

________________________________________________________________________________________

Organizational/Planning 5 4 3 2 1 N/A

Manages projects and or other projects

effectively _______

Sets goals and prioritizes _______

Manages several tasks at once _______

Allocates time to meet deadlines _______

________________________________________________________________________________________

Evaluation of Work Habits 5 4 3 2 1 N/A

Professional attitude toward work

assigned _______

Quality of work produced _______

Volume of work produced _______

Attendance and punctuality _______

Does student appear to be progressing successfully? _______yes _______no

Please explain:________________________________________________________

____________________________________________________________________

List student’s specific strengths:__________________________________________

____________________________________________________________________

List areas of concern regarding student’s performance:________________________

____________________________________________________________________

Summary Evaluation of Performance

^{Assessment of
student’s performance to support overall evaluation below:}

____________________________________________________________________

Overall Evaluation:

(A) (B) (C) (D) (F)

Excellent Good Satisfactory Poor Unsatisfactory

Growth & Future Development

^{To assist the
student in the upcoming semester, please complete the following section:}

What are your goals for the student for the next co-op term?_________________

__________________________________________________________

What suggestions would you make to help the student become more successful? __________________________________________________________

__________________________________________________________

What courses or specific training would you suggest to help the student

develop professionally? __________________________________________

___________________________________________________________

Has this report been discussed wit the student? _______yes _______no

Rate of pay:________per hour

Do you recommend student for continued co-op employment with your organization?

_______yes ________no

If no, please explain:____________________________________________________

_____________________________________________________________________

List all individuals who have had input into this evaluation:

Name:__________________________________ Name:________________________

Evaluator’s Signature:_______________________Position:____________Date:_____

Student’s Signature:______________________________Date:___________________