Field Placement Evaluation Form

Student Name: Student Number:

Program Name: Date:
Company Name:

To be completed by employer. Students must also submit the Field Placement Description into the Placement Manager in order to
satisfy their PRAC Field Placement requirements. Completion of this form ensures a Field Placement grade is issued to the student.

ATTITUDE DEPENDABILITY
 High interest in job. Very enthusiastic.  Can always be depended upon in any situation.
 More than average interest and enthusiasm for the job.  Can usually be depended upon in most situations.
 Satisfactory amount of interest and enthusiasm for the job.  Can be depended upon in routine situations.
 Occasionally enthusiastic.  Somewhat unreliable, needs frequent checking.
 Little interest or enthusiasm for the job.  Unreliable.

RELATIONSHIP WITH STAFF

INITIATIVE  Always works well with others. Excellent team worker.
 Self-starter. Asks for new tasks. Looks for activities to be involved  Congenial, helpful. Works well with associates.
in.  Relations with others are peaceful under normal circumstances.
 Acts voluntarily in most matters.  Difficult to work with at times. Sometimes antagonizes others.
 Acts voluntarily in routine matters.  Frequently quarrelsome and causes friction.
 Relies on others. Must be told what to do frequently.
 Always waits to be told what to do next. ACCEPTANCE OF SUGGESTIONS & CRITICISM
 Expresses appreciation and takes prompt action on suggestions.
 Willingly accepts criticism by supervisor.
ABILITY TO LEARN  Accepts suggestions and criticism in satisfactory manner.
 Quick to learn.  Reluctantly accepts suggestions and criticism by supervisor.
 Average.  Resents suggestions and criticism by supervisor.
 Rather slow to learn.
 Very slow to learn. COMMUNICATION SKILLS-ORAL
 Not applicable.  Excellent
 Good
 Needs improvement
ORGANIZATION AND PLANNING  Not applicable
 Does an outstanding job of planning and organizing work.
 Does an adequate amount of planning and organizing. COMMUNICATION SKILLS-WRITTEN
 More often than not fails to organize and plan work effectively.  Excellent
 Not applicable.  Good
 Needs improvement
 Not applicable
QUALITY OF WORK
 Very thorough in performing work; very few errors. APPEARANCE
 Usually thorough. Good work. Few errors.  Appropriate
 Work usually passes review. Normal amount of errors.  Inappropriate
 More than average amount of errors for a trainee.
 Work usually done in careless manner. Often errors. ATTENDANCE
 Not applicable.  Regular
 Irregular
JUDGEMENT PUNCTUALITY
 Very good. Decisions based on complete analysis of problem.
 Regular
 Uses common sense. Usually makes good decisions.
 Irregular
 Judgment usually good in routine situations.
 Judgment often undependable. OVERALL PERFORMANCE
 Not applicable.
 Excellent
 Above average
 Satisfactory
 Needs improvement
 Unsatisfactory
Please complete reverse side.
STUDENT’S STRENGTHS
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AREAS FOR IMPROVEMENT

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SUGGESTIONS FOR PROGRAM/FIELD PLACEMENT IMPROVEMENT

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Has the evaluation been discussed with the student? Yes No

TOTAL NUMBER OF HOURS THE STUDENT SPENT AT FIELD

PLACEMENT:
SUPERVISOR’S NAME:

SUPERVISOR’S SIGNATURE: DATE:

STUDENT’S NAME:

STUDENT’S SIGNATURE: DATE:

We appreciate your support of Niagara College - Toronto’s Field Placement Program.