Mentor Internship Program Evaluation

| resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.





Mentor's Evaluation







Mentor Grade Recommendation

Please respond to the following statements. Your response assists the Ministry/Counseling Internship Director in formulating the term grade for this student. Think carefully about each question and then rate the student on the scale provided below.

5 Exemplary

Regarding this character trait or skill the intern is a role model for others or has taught it to others.

4 Excellent

The student is proficient in the demonstration of this character trait or skill.  

3 Growing

The student demonstrates growth in the development of this character trait or skill.  The student needs development in this area..

2 Deficient

The student is deficient with the demonstration of this character trait or skill.  Significant improvement is needed.

1 Poor

The student is poor in the demonstration of this character trait or skill.

0 = Not Applicable






























































Captcha

Please enter the characters you see in this picture:

Visual CAPTCHA

This helps prevent automated form submissions. If you are not sure what the characters are, make your best guess. You will have another try in the next screen.
Can't see the image? Click here for an audible version in English.

Need assistance with this form?