Republic of the Philippines

CENTRAL LUZON STATE UNIVERSITY

Science City of Muñoz, Nueva Ecija

COLLEGE OF BUSINESS ADMINISTRATION AND ACCOUNTANCY

COOPERATING AGENCY PRACTICUM RATING SHEET FOR STUDENT

Name of Student: _______________________________ Course: ____________

Office/Department assigned: _________________________________________
Cooperating Agency: ________________________________________________
Address: ______________________________________ Contact No.__________
Practicum Period (Inclusive Dates):____________________________________
Total No. of Hours Completed: ____________________ No. of Days Absent: ___

A. On Performance 60% _____

Technical Knowledge Gained 15% ________
Office/Mngt. Skills Developed 15% ________
Quantity of Work Output 15% ________
Quality of Work Output 15% ________

B. On Personal & Social Qualities 30% _____

Punctuality 5% ________
Industriousness 5% ________
Dependability 5% ________
Initiative 5% ________
Working Relations w/ Others 5% ________
Working Relation w/ Supervisor 5% ________

C. Attendance 10% _____

TOTAL 100% =======

FEEDBACKS:
_______________________________________________________________
________________________________________________________________
________________________________________________________________

________________________________
SUPERVISOR
Signature over Printed Name

Practicum Form 6

ACA.CBA.YYY.F.006 (Revision No. 0; April 2, 2018)