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Communiity Partner Evaluation of CBL Student
Preferred Name
Last Name
Email
Colleague ID
Class Level
Degree Completed
First Year
Graduate
Junior
Senior
Sophomore
Mobile
Community Partner Information
Community Agency/Program
*
Community Partner/Supervisor Name
*
Student Information
Student First Name
*
Student Last Name
*
Semester
*
Year
*
Course Number
*
Total Hours (student has completed to date)
*
Evaluate Student
Reliability: Did the student arrive on time and stay entire time on scheduled visit days?
*
Reliability: Did the student arrive on time and stay entire time on scheduled visit days?
*
poor
average
good
excellent
N/A
Ability of student to notify you in advance if he/she could not attend placement and schedule a time to make up hours?
*
Ability of student to notify you in advance if he/she could not attend placement and schedule a time to make up hours?
*
poor
average
good
excellent
N/A
Ability of student to adapt to the agency environment
*
Ability of student to adapt to the agency environment
*
poor
average
good
excellent
N/A
Ability of student to be resourceful
*
Ability of student to be resourceful
*
poor
average
good
excellent
N/A
Willingness to take initiative
*
Willingness to take initiative
*
poor
average
good
excellent
N/A
Ability of the student to follow directions/instructions
*
Ability of the student to follow directions/instructions
*
poor
average
good
excellent
N/A
Ability of the student to demonstrate patience
*
Ability of the student to demonstrate patience
*
poor
average
good
excellent
N/A
Ability to cooperate with peers, support staff and clients/guests
*
Ability to cooperate with peers, support staff and clients/guests
*
poor
average
good
excellent
N/A
Ability to accept and utilize criticism
*
Ability to accept and utilize criticism
*
poor
average
good
excellent
N/A
OVERALL performance of the student at the agency
*
OVERALL performance of the student at the agency
*
poor
average
good
excellent
N/A
OVERALL attitude of the student
*
OVERALL attitude of the student
*
poor
average
good
excellent
N/A
What specific projects/tasks were completed by the student during his/her placement with your agency?
*
Comments
Additional Comments
*
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