BOHOL ISLAND STATE UNIVERSITY

[Campus]
[Office]

Vision: A premier Science and Technology university for the formation of world class and virtuous human resource for sustainable
development in Bohol and the country.

Mission: BISU is committed to provide quality higher education in the arts and sciences, as well as in the professional and technological
fields; undertake research and development and extension services for the sustainable development of Bohol and the country.

GENERAL INTERNSHIP EVALUATION FORM

Name of the Intern :

Name of the HTE :
HTE Address: :
HTE Department :
Internship Period : Start: _________________ End: _________________

Direction: Kindly assess the tasks/competencies based on the scale below:

Rating Scale:
1 - Outstanding (always manifests job skills/competencies/attitudes with excellence)
2 - Very Satisfactory (frequently manifests job skills/competencies/attitudes with excellence)
3 - Satisfactory (sometimes manifests job skills/competencies/attitudes with excellence)
4 - Fair (sometimes manifests job skills/competencies/attitudes with mediocrity)
5 - Needs Improvement (manifests job skills/competencies/attitudes with mediocrity most of the time)
N/A - Not applied (No opportunity to be exposed to the identified tasks and competencies)

Evaluation Criteria Period Ratings Signature of

Supervisor/Mentor
1 2 3 4 5 N/A
A. Job Performance (80%) (Tasks/Competencies based on Program CMO)
Competencies Description
a. Exhibit competence in
mathematical concepts and
procedures.

b. Exhibit proficiency in
relating mathematics to other
curricular areas.
c. Manifest meaningful and
comprehensive pedagogical
content knowledge (PCK) of
mathematics.
d. Demonstrate competence
in designing, constructing,
and utilizing different forms of
assessment in mathematics.
e. Demonstrate proficiency in
problem-solving by solving
and creating routine and non-
routine problems with
different levels of complexity.
f. Use effectively appropriate
approaches, methods, and
techniques in teaching
mathematics including
technological tools.
g. Appreciate mathematics
as an opportunity for creative
work, moments of discovery,
F-AQA-INS-014 | Rev. 1 | 09/18/23 | Page 1 of 4
 BOHOL ISLAND STATE UNIVERSITY
[Campus]
[Office]

Vision: A premier Science and Technology university for the formation of world class and virtuous human resource for sustainable
development in Bohol and the country.

Mission: BISU is committed to provide quality higher education in the arts and sciences, as well as in the professional and technological
fields; undertake research and development and extension services for the sustainable development of Bohol and the country.

GENERAL INTERNSHIP EVALUATION FORM

and gaining insights of the
world.
B. Life Skills (20%
takes direction and
Cooperativeness/ guidance from
Collaboration superior openly and
positively

observes proper
decorum in dealing
Human Relations
with co-workers/
superiors

influences others in
Leadership the team to
accomplish targets
makes sound
Decision- making/ problem judgment and
solving manifest critical
thinking
sets clear targets in
Planning and organization
the completion of
skills
assigned tasks
prioritizes multiple
Adaptability
tasks
executes and
completes work as
Dependability, Reliability and instructed
Resourcefulness works with
minimum amount of
supervision
communicates
orally effectively
Communication Skills
communicates in
writing effectively
demonstrates
Filipino values and
industry desired
values
demonstrates
commitment to the
Conduct
job
complies with
internship/OJT
guidelines and
requirements of the
company
reports to work
Attendance/ Punctuality
punctually

F-AQA-INS-014 | Rev. 1 | 09/18/23 | Page 2 of 4

 BOHOL ISLAND STATE UNIVERSITY
[Campus]
[Office]

Vision: A premier Science and Technology university for the formation of world class and virtuous human resource for sustainable
development in Bohol and the country.

Mission: BISU is committed to provide quality higher education in the arts and sciences, as well as in the professional and technological
fields; undertake research and development and extension services for the sustainable development of Bohol and the country.

GENERAL INTERNSHIP EVALUATION FORM

reports to work
regularly
Weighted Average
Description

<Signature over printed name of Immediate Supervisor>

Annex D-2. Range of Ratings

Range of Ratings (Based on the Student Manual)

Grades Description
1.0 – 1.29 Outstanding
1.30 – 1.59 Very Satisfactory
1.60 – 2.59 Satisfactory
2.60 – 3.09 Fair
3.1 – 5.0 Needs Improvement/ Failed

Annex D-3. SIPP Coordinating Rating Sheet

Rating Sheet for the Internship

Course & Field of

Name of Student : :
Specialization
Business Name : Business Hours :
Business Address :

For SIPP only

Criteria Score Rating Equivalent

F-AQA-INS-014 | Rev. 1 | 09/18/23 | Page 3 of 4
 BOHOL ISLAND STATE UNIVERSITY
[Campus]
[Office]

Vision: A premier Science and Technology university for the formation of world class and virtuous human resource for sustainable
development in Bohol and the country.

Mission: BISU is committed to provide quality higher education in the arts and sciences, as well as in the professional and technological
fields; undertake research and development and extension services for the sustainable development of Bohol and the country.

GENERAL INTERNSHIP EVALUATION FORM

a. Timeliness (punctual submission of reports) (60%)
b. Propriety and Decorum (proper conduct and
behavior in the workplace) (40%)
Total

Score Rating Equivalent

1. HTE Rating (90%)
2. SIPP Coordinator Rating (10%)
Total

Total
& Equivalent
Final Grade Eq.
Rated by:

<Name of SIPP Coordinator> <Name of Dean>

F-AQA-INS-014 | Rev. 1 | 09/18/23 | Page 4 of 4