Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Calauan, Laguna Campus

EVALUATION INSTRUMENT FOR STUDENT-INTERN

Intern’s Name
Academic Program
Section
Host Training
Establishment Name
Intern’s Job Description

Evaluator’s Name
Position
E-mail Address
Date of Evaluation

Evaluator’s Signature

MAXIMUM
CHARACTER (50%) RATING TO BE RATING
GIVEN

1. The intern can be trusted with important and confidential

10%
information.
2. The intern shows courtesy and transparency in his/ her dealings
10%
with superiors and colleagues.
3. The intern displays responsibility and accountability in doing the
10%
assigned tasks.
4. The intern manifests resiliency during critical and difficult
10%
circumstances.
5. The intern shows commitment and hard work in the workplace. 10%

COMPETENCE (50%)
6. The intern displays thoroughness, accuracy, and completeness
5%
in work output.
7. The intern practices timeliness in the completion of assigned
5%
tasks.
8. The intern manifests sound decision-making and logical thinking
10%
in dealing with simple problems related to his/her tasks.
9. The intern exhibits initiative and perseverance in the
10%
performance of duties and responsibilities.
10. The intern meets the technical skills required of the student
intern by the HTE: 15%
Please specify: ______________________________ (distribution of this
rating depends on
______________________________ skills specified)
______________________________
11. The intern shows great potential for employment in the
5%
company.

THE COUNTRY’S 1st POLYTECHNICU

 TOTAL RATING (100%)

Further Recommendation for the Student -Intern’s Growth:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Name of Evaluator : ____________________________

Designation : ____________________________
Date: : ____________________________

Conforme:

[Signature over Student-Intern’s Name]

THE COUNTRY’S 1st POLYTECHNICU

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 FINAL GRADE
(to be given by the Internship Adviser)

CATEGORY PERCENTAGE GRADE

OBTAINED

1. Class Standing (30%)

2. Portfolio (30%)

3. Training
Supervisor (40%)
Evaluation

TOTAL (100%)

___________________________________________
[Signature over Full Name of Internship Adviser]

THE COUNTRY’S 1st POLYTECHNICU

Page 3 of 4
 SUMMARY OF GRADE

Final Evaluation Result Final Grade

Training Supervisor

Internship Adviser

TOTAL

___________________________________________
[Signature over Full Name of Internship Adviser]

THE COUNTRY’S 1st POLYTECHNICU

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