"Student Self-evaluation of Volunteer / Work Experience Form - Oak Bay High School"

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STUDENT SELF-EVALUATION OF VOLUNTEER / WORK EXPERIENCE
From:
_______
Student:
To:
______
Program: Graduation Transition Plan
Total Hours:
Please rate yourself by circling the number which
best describes your performance for each of the
Placement:
criteria.
Job Description:
4
Outstanding
3
Good
2
Fair
1
Needs improvement
N/A (not applicable)
GENERAL WORK SKILLS YOU HAVE DEVELOPED
Personal and Social Aptitudes
Reflect on specific work skills you learned
and on your quality of work performance
during your Volunteer/Work Experience.
Acceptance of constructive criticism
4
3
2
1
NA
Appearance
4
3
2
1
NA
Punctuality
4
3
2
1
NA
Attendance
4
3
2
1
NA
Courtesy (with public & workers)
4
3
2
1
NA
Dependability and responsibility
4
3
2
1
NA
Work Qualities and Habits
Effort
4
3
2
1
NA
(initiative, eagerness, effectiveness)
What have you learned from this experience
Dexterity
4
3
2
1
NA
that you can/will apply in the future?
(speed, accuracy, organization)
Follow through
4
3
2
1
NA
(completing tasks, projects)
Communication Skills
Verbal (speaking clearly)
4
3
2
1
NA
Listening (able to follow directions)
4
3
2
1
NA
Questioning
4
3
2
1
NA
(asking appropriate questions)
Non-verbal
(eye contact, body language)
4
3
2
1
NA
Student Signature:
Written
4
3
2
1
NA
Transition Advisor Signature: _______
(writing clearly, concisely, & legibly)
Date:
STUDENT SELF-EVALUATION OF VOLUNTEER / WORK EXPERIENCE
From:
_______
Student:
To:
______
Program: Graduation Transition Plan
Total Hours:
Please rate yourself by circling the number which
best describes your performance for each of the
Placement:
criteria.
Job Description:
4
Outstanding
3
Good
2
Fair
1
Needs improvement
N/A (not applicable)
GENERAL WORK SKILLS YOU HAVE DEVELOPED
Personal and Social Aptitudes
Reflect on specific work skills you learned
and on your quality of work performance
during your Volunteer/Work Experience.
Acceptance of constructive criticism
4
3
2
1
NA
Appearance
4
3
2
1
NA
Punctuality
4
3
2
1
NA
Attendance
4
3
2
1
NA
Courtesy (with public & workers)
4
3
2
1
NA
Dependability and responsibility
4
3
2
1
NA
Work Qualities and Habits
Effort
4
3
2
1
NA
(initiative, eagerness, effectiveness)
What have you learned from this experience
Dexterity
4
3
2
1
NA
that you can/will apply in the future?
(speed, accuracy, organization)
Follow through
4
3
2
1
NA
(completing tasks, projects)
Communication Skills
Verbal (speaking clearly)
4
3
2
1
NA
Listening (able to follow directions)
4
3
2
1
NA
Questioning
4
3
2
1
NA
(asking appropriate questions)
Non-verbal
(eye contact, body language)
4
3
2
1
NA
Student Signature:
Written
4
3
2
1
NA
Transition Advisor Signature: _______
(writing clearly, concisely, & legibly)
Date:
SUPERVISOR EVALUATION OF A VOLUNTEER/WORK EXPERIENCE STUDENT
STUDENT INFORMATION
WORK EXPERIENCE
Name: ________________________________
Dates of Volunteer/Work Experience:
Program: Graduation Transition Plan
______________ to ____________ 20 ___
Teacher: ____________________________
Work Site:
_________________________
School:
____________________________
Phone: _____________ Fax: __________
Address:
___________________________
Supervisor:
________________________
___________________________________
Duties Performed:
___________________
Tel: _______________ Fax: ___________
__________________________________
PLEASE EVALUATE this VOLUNTEER/WORK EXPERIENCE STUDENT as you would a NOVICE WORKER and,
if possible, DISCUSS this EVALUATION with the STUDENT
Please evaluate the student on the four-point scale below:
4: Outstanding
3: Good
2: Fair
1: Needs Improvement
NA: Not Applicable
PERSONAL AND SOCIAL APTITUDES
QUALITY of WORK and WORK HABITS
Reliable
4
3
2
1
NA
Cooperative
4
3
2
1
NA
Shows good work ethic
4
3
2
1
NA
Accepting of constructive criticism
4
3
2
1
NA
Shows initiative: self-starter
4
3
2
1
NA
Adaptable to new tasks/situations
4
3
2
1
NA
Able to follow directions
4
3
2
1
NA
Respectful of others
4
3
2
1
NA
Completes assigned tasks
4
3
2
1
NA
Appropriately groomed
4
3
2
1
NA
Able to solve problems
4
3
2
1
NA
Demonstrates a positive attitude
4
3
2
1
NA
to job and organization
Aware of safety practices
4
3
2
1
NA
Shows interest and enthusiasm
4
3
2
1
NA
Uses technology effectively
4
3
2
1
NA
Punctual
4
3
2
1
NA
Attends regularly
4
3
2
1
NA
COMMUNICATION SKILLS
Recommendations for improvement and additional
Speaks clearly
4
3
2
1
NA
comments:
Listens well
4
3
2
1
NA
_____________________________________________
Uses appropriate body language
4
3
2
1
NA
Writes clearly and legibly
4
3
2
1
NA
_____________________________________________
_____________________________________________
FINAL ASSESSMENT
_____________________________________________
Overall work experience
4
3
2
1
NA
_____________________________________________
_____________________________________________
Has this report been discussed with the student? Yes
No
Supervisor’s Signature:
_____________________________________________
Student’s Signature: _________________________
_____________________________________________
Date:
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