Career Cohort

Weekly Evaluation Report

Student Name:

Monday's Date:

Company/Employer Name:

Friday's Date:

Company/Employer Telephone #:

# of Hours
Worked

Student Responsibility: Turn in this form to Mrs. Simons by the following Wednesday of each week.
Late work will not be accepted and can not be made up.
Employer Responsibility: Please complete the table below; share your ratings with the student.
Sign verifiying attendance and performance; give this form to the student to return to the teacher.
Thank you.

Evaluation
Scale:

1 - Poor
Trait

2 - Needs Improvement
Rating

3 - Average

4 - Good
Trait

5 - Excelllent
Rating

Attendance/Punctuality

5 Cooperation

Attitude

5 Time Management

Dependability

5 Quality of Work

Attendance
Day

Mon

Tues

Weds

Thurs

Date
Hours Worked

Signature of Student:

Date:

Signature of Supervisor:

Date:

Fri