| Student Name |
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| Class |
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| Major/Minor |
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| Term |
/ |
| Placement |
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| Employer |
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| Employer Location |
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| Department or Work Area |
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| Job Title |
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| Dates worked |
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| Number of hours/week |
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| Rate of pay |
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| Total Earnings for Term |
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| Have you worked with this employer before? |
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| Supervisor |
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| Supervisor's Phone # |
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1. Briefly describe your assignment |
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2. What were the best features of this assignment? |
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3. Did you utilize specific knowledge and skills related to your major/career in this assignment. Explain. |
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4. Discuss the specific relationship of this assignment to your major/minor or your career interests? |
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5. Did you accomplish your learning objectives? If no, explain why not. |
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6. What additional work skills and/or knowledge did you acquire through this experience, i.e., computer/technical, analytical,
research, writing, etc? |
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7. Was the work you performed challenging and stimulating? Did this assignment meet/exceed your expectations? Explain. |
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8. Describe your relationship with your employer in general and your supervisor in particular. (i.e., given proper amount of direction and guidance, availability, being concerned about you as an individual, etc.) |
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9. Will you be returning to this employer for another placement? If so, when? |
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10. Were you offered a full-time job upon completion of your experience or upon graduation; and did you accept the offer? |
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11. How could our office or your faculty advisor have helped to improve your experience? |
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Typing your name denotes your official signature
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