Internship Evaluation of University Supervisor
Please complete this evaluation. The form will be sent to the Office of Field Experience and yourself. Note that the University Supervisor does not receive a copy of it through this online form.
Please rate your University Supervisor member on the following statements. Select either Satisfactory or Unsatisfactory on the rating scale below.
Current Status: *
Undergraduate Student Teaching
Graduate Student Teaching
Intern Name: *
Please select one
University Supervisor Data
University Supervisor Name: *
Today's Date:
2/15/2026 2:10:18 PM
School:
Content Area/Grade Level:
Responsibility 1: Building Positive Relationships
A. Creates a positive, professional relationship with intern and clinical educator:
Satisfactory
Unsatisfactory
Comments:
Responsibility 2: Knowledge
A. Knows current best practices and assists the intern in improving planning, instruction, and assessment skills:
Satisfactory
Unsatisfactory
Comments:
B. Offers effective help to intern with a focus on improving P-12 student learning:
Satisfactory
Unsatisfactory
Comments:
Responsibility 3: Conferencing and Assessment Skills
A. Clearly communicates to intern goals and timelines for observations and TWS:
Satisfactory
Unsatisfactory
Comments:
B. Formally and fairly observes and evaluates intern performance based on rubric descriptors:
Satisfactory
Unsatisfactory
Comments:
Responsibility 4: Communication
A. Clearly communicates expectations, goals, objectives, policies to intern:
Satisfactory
Unsatisfactory
Comments:
B. Works effectively to help solve problems regarding intern performance concerns or other placement issues, including following POA Protocol, if necessary:
Satisfactory
Unsatisfactory
Comments:
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