SCWK 440

SCWK 202

Supervisor's Final Evaluation Form

SUPERVISOR'S EVALUATION OF STUDENT'S PERFORMANCE

SW 202 - SPECIAL DIRECTED VOLUNTEER EXPERIENCE

Student's Name: __________________________________________________

Agency: __________________________________________________

Address: __________________________________________________

__________________________________________________

Supervisor's Name: __________________________________________________

1. Number of hours completed by student:

________ a. less than 80 clock hours

________ b. 80 clock hours

________ c. more than 80 clock hours

2. Was the student: Please circle one:

a. Paid for working: Yes No Sometimes

b. Prompt: Yes No Sometimes

c. Dependable: Yes No Sometimes

d. Cooperative: Yes No Sometimes

3. Please comment on the student's demonstration of the following:

Initiative:

Motivation:

3. Please comment on the student's demonstration of the following: (Cont.)

Leadership, i.e., planning, organizing, decision-making:

Self-discipline:

Ability to establish rapport with staff:

Ability to effectively communicate:

Orally:

Written form:

Use of supervision:

Attendance at scheduled conference:

Willingness to accept responsibility:

Follow through with assigned tasks:

Ability to accept constructive criticism:

Ability to critically examine self:

_________________________________________ _______________________

Agency Supervisor Date

I acknowledge that this evaluation was shared with me by the agency supervisor., My acknowledgment does not indicate agreement or non-agreement with the evaluation contained in this report. I am aware that I can write additional material on any point in the evaluation after the evaluation is discussed with agency supervisor.

_______________________________________ _______________________

Student Volunteer Date

______________________________________ _______________________

Course Instructor Date