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Republic of the Philippines

CAVITE STATE UNIVERSITY


Don Severino de las Alas Campus
Indang, Cavite
 (046) 4150-010 / (046) 4150-013 loc 206
www.cvsu.edu.ph

COLLEGE OF ENGINEERING AND INFORMATION TECHNOLOGY


Department of Information Technology

STUDENT INTERNSHIP PROGRAM IN THE PHILLIPINES (SIPP) EVALUATION FORM*

Name of the Student Intern:


Name and address of the Host Training Establishment:

Inclusive Period of Internship: From To


Total No. of hours rendered by the student intern:

Department Assigned Tasks Performed Period Student Outcomes Ratings Signature of


Supervisor/Mentor

Rating legend: 5 – Excellent; 4 – Average; 3 – Good; 2 – Fair; 1 – Poor

*Based on CHED Memo No. 104 Series of 2017


**Please use additional sheets if necessary

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