Education Services 2020

Internship Evaluation Form

Student Name:
Host Teacher: Host School:
Grade Level/Content Area: Dates of Internship:

Date Day Time In Time Out Date Day Time In Time Out

For the following attributes, rate the student according to the following scale:
4= Superior, outstanding The teacher becomes a mediator of
3= Strong, above average knowledge, a promoter of dignity,
responsibility and self-worth, and a
2= Average coordinator of learning by developing
1= Below average professionally. The student will have access
to this information.
0= Inadequate

Professional Development: A B C D F
4 3 2 1 0
A. Enthusiasm working with students and X
engaged in lessons
B. Laptop and Cell Phone Put Away (unless X
for an assignment)
C. Responsibility- Completion of tasks and X
willingness to get involved
D. Rapport- ability to relate to students X
E. Appearance clean, dressed like a X
teacher
 F. Courtesy and tact uses appropriate X
teacher language
G. Self-confidence jumps in and takes X
initiative without being asked
H. Attendance punctual and communicates X
with host teacher when needed
Comments: Emily is very conscientious and aware of classroom needs.

+ (Strengths) Delta (Opportunity for Improvement)

Assesses situations naturally

Asks if there is something she can do to help Continue to push outside of your comfort
Always positive with students and me zone
Trust your instincts(you have good ones)

Verified by
Julie Bono 12/8/17
Host Teacher Date

PHPS Instructor Date

Student Date