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Bonaventure University Intern Evaluation Form for Internship

Site Supervisors Evaluation Form

XX

XX University Supervisors Evaluation Form

The criteria evaluated on this form are based upon and reflective of the Knowledge,
Skills and Dispositions mentioned on pages 4-5 of the Internship Guide. They are
coded by their appropriate K, S, and D numbers below.
Please check the appropriate box indicating which evaluation form you are filing. Make
copies of this evaluation form for each supervisors as well as the interns evaluation.
Interns Name

Kirsten Henderson

Site Supervisors Name

Christine Lewis

University Supervisors Name

Mary Kay Worth, 400 hour component

I. OVERALL EVALUATION
Please indicate a general evaluation of the accomplishment of the stated competencies
of the internship.
(Check One)
XX

XX Outstanding

Very Good

Good

Satisfactory

Unsatisfactory

COMMENTS: (Use additional sheet if necessary)

The accolades adeptly articulated in the evaluation from Kirstens 400 hour site
supervisor attest to the skills and motivation demonstrated throughout this first
SBL internship component in a preschool through age 8 special education setting.
As we neared the end, Kirsten was already shifting her thinking into other valuable
ideas to add to her electronic records as evidence of her desire to shape and lead
an organization. I particularly appreciated her willingness to successfully search for
and secure the 200 hour component in a public school setting with and age group
(secondary) not in her comfort zone. These are earmarks of an individual who is a
self-starter who seeks advice and counsel regularly from seasoned administrators. I
concur with the remarks penned by her site supervisor, With the initiative Kirsten
put forth, and the many administrative responsibilities she experienced, she is well
on her way to becoming a strong and effective school leader.

II.

PROFESSIONAL CRITERIA

For each of the criteria listed below, please provide both a numerical self-evaluation and
any pertinent comments about the internship experience.
For numerical evaluation, use the following scale:
5Outstanding
A)

4 - Very
Good

3 - Good

2Satisfactory

1Unsatisfactor
y

4
LEADERSHIP ABILITY (K1, K2, K3, S3, D1, D4, D6 - e.g. ability to inspire other,
set and reach goals, create positive action, solve problems, etc.)

COMMENTS:
Her knowledge of special education and drive to understand the organization and
management of a private, pre- school setting is very good.

B)

5
PROFESSIONAL MOTIVATION (D3, D4 - e. g. clear goals, high level of
professional interest and motivation, etc.)

COMMENTS:
An asset worthy of special comment is in the documented number of incidents
where Kirsten saw a need at the Childrens League, presented it to her site
supervisor, and was given the GO to research, plan, and present/implement.

C)

5
PERSONAL CHARACTERISTICS (D2, D5, D6 - e.g. sense of humor, poise, selfcontrol, ability to handle crises and stress, honest, etc.)

COMMENTS:
Although she lives with teens and a spouse with technology strengths, Kirsten
honestly recognized early on her need to seek their assistance to not only meet
the requirements of the internship, but also improve her own competency. Her site
supervisor especially appreciated that Kirsten volunteered to collaborate with a
difficult colleague and showed personal strength, integrity, and professionalism
while juggling the responsibilities of home, her studies, and her employment.
D)

5
INTERPERSONAL RELATIONS (D2, D3, D4, D4, D6 - e.g. ability to relate to
others, work with groups, acceptance of criticism, respect for others, etc.)

COMMENTS:

I have only witnessed professionalism from Kirsten.

E)

5
PROFESSIONAL COMPETENCE (K1, K2, K3, S1, S2, S3, D1, D2, D3, D4, D6 e.g. successful completion of tasks and assignments, demonstrates understanding of
nature of administration, includes dependability, demonstrates initiative, assumes
responsibility, able to work independently, punctual, etc.)

COMMENTS:
Kirsten met deadlines and consistently showed understanding of the nature of
administrative leadership.

F)

5
WRITTEN COMMUNICATION (S1, S2 - e.g. fluency, accuracy, command of the
language, timeliness, grammar, etc.)

COMMENTS:
Kirstens skill set here is spot on.

G)

4
ORAL COMMUNICATION (S1, S2 - e.g. fluency, poise ability to articulate,
enunciation, grammar, etc.)

COMMENTS:
While her oral communication is very good, I concur with her site supervisor:
improvement in speaking more slowly and concisely will pay dividends.

H) ADDITIONAL COMMENTS (Comments/observations not covered in prior question

areas)
It has been my pleasure to assist Kirsten in her quest for administrative
certification throughout this 400 component. She made my role as University
Supervisor easy and I feel certain that she will be successful in landing a
leadership position when she begins the search.

Signature

November 16, 2015

Date