You are on page 1of 2

Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Quezon
PATABOG NATIONAL HIGH SCHOOL
SENIOR HIGH SCHOOL
Mulanay, Quezon
Page 1 of 1

Name of the Trainee: Immersion Coordinator: Mr. Nomerto M. Revilla Jr.

Work Immersion Cooperating Industry: Immersion Supervisor:

WORK IMMERSION EVALUATION FORM

Directions: Kindly rate the Work Immersion Trainee/Student’s performance according to the rating scale
below. Please a check (/) mark on the space that corresponds to your given rating.

5 Outstanding (O) Trainee/Student’s performance was impressive 90-100


and outstanding. It exceeded that performance on
the trainee/student on the tasks and/or activities
assigned to him/her
4 Very Satisfactory Trainee/Student’s performance satisfied the 85-89
(VS) expectations of the industry supervisor
concerning the tasks/activities assigned to
him/her
3 Satisfactory (S) Trainees/Student’s performance satisfied the 80-84
expectations of the industry supervisor
concerning the tasks/activities assigned to
him/her. But, one or two areas still had to be
improved.
2 Fairly Satisfactory Work performance was okay, but there were lots 75-79
(FS) of areas that have to be given attention to at least
satisfy the target competencies.
1 Failed (F) Did not Meet Expectations 74 below

The work immersion trainee/student…


Work Habit Formation 5 4 3 2 1
1 Always come on time
2 Comes to work regularly and religiously
3 Show passion. Commitment and dedication
4 Performs tasks/activities independently
5 Demonstrates self-discipline, self-accountability and flexibility
6 Observes appropriate ethical behavior and/or attitude
7 Prioritizes and observes safety-conscious actions
8 Demonstrates honesty and dependability
Score

Work Skills and Competence 5 4 3 2 1


1 Handles details of the given tasks/activities
2 Provides relevant feedback to the management or supervisor
3 Performs the tasks based on the job/work description
4 Suggest solutions to problems
5 Can troubleshoot immediate concerns and issues by providing solutions to
problem
6 Can manipulate the tools and/or equipment in the workplace concerning
the assigned tasks recorded to his/her specialization.
Score

Interpersonal and Human Relations Skills 5 4 3 2 1


1 Show respect in dealing with clients and industry supervisor
2 In properly groomed and well-poised
3 Accepts suggestions from industry supervisor, co-workers and co-trainee
in improving work performance
4 Demonstrates appropriate eye contact, gestures and language in dealing
with others in various situations
5 Demonstrates emotional maturity and stability.
Score

Comments:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

______________________________________ __________________________
Signature overprinted name of WI Supervisor Date

You might also like