ÐÏࡱá>þÿ PRþÿÿÿOÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á#` ð¿f!bjbj\.\. 48>¶Ù>¶Ù³¢ÿÿÿÿÿÿ¤°ª°ª°ª°ª°ª°ª°ª°Õœ%œ%œ%8Ô%ð%<T–.¶8&8&N&N&N&N&N&N&.......$L/h´1¬;.@+*N&N&+*+*;.@@N&N&P.)-)-)-+*d@N&@N&.)-+*.)-)-@@)-N&,& À6GGSEÇœ%*p)-.f.0–.)-`2ÿ*º`2)-`2@)-ìN&®ü&|)-x'dÜ'ON&N&N&;.;.¹,pN&N&N&–.+*+*+*+*TTTÄ„ TTTTTT@@@@@@ÿÿÿÿ Eastern Illinois University Department of Counseling and Student Development College Student Affairs Program CSD 5880 - Internship in Student Affairs Supervisor Evaluation [To be completed by the on-sight supervisor] Please rate the student who completed an internship in your area. Include any comments that will assist the course instructor in assigning a pass/fail grade. A meeting with the student for a final evaluation prior to the returning of this evaluation to the course instructor is recommended. Student’s Name: _________________________________ Date: __________________ Institution: __________________________________ Department: ______________________ Rating Scale: 1 = completely failed to meet expectations 2 = minimally adequate but less than expected 3 = satisfactory met expectations 4 = exceeded expectations 5 = exceptional performance N = No opportunity to observe (or practice) 1. Personal warmth and ability to relate to individuals (Âé¶¹´«Ã½/faculty/admin) from diverse backgrounds. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 2. Willingness to listen and effectively communicate information verbally. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 3. Ability to work with departmental personnel (clerical and professional). Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 4. Administrative skills and ability to work without close supervision. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 5. Leadership, group work, and counseling skills. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 6. Takes initiative to complete tasks and seeks opportunities to learn. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 7. General and specific knowledge of departmental responsibilities and activities. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 8. Participation in departmental activities. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 9. Knowledge of student development theories and ability to utilize them in practice. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 10. Potential as student affairs professional. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 11. Level of motivation to complete agreed upon goals and assignments. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 12. Confidence and sense of personal ability. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 13. Observable professional growth. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 14. Research skills. Circle one: 1 2 3 4 5 N/A Comments: ____________________________________________________________________________________________________________________________________________________________ 15. Problem solving ability. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 16. Written communication skills. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 17. Progress towards goals. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 18. Specific area(s) of strength. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 19. Suggested areas for improvement. Circle one: 1 2 3 4 5 N Comments: ____________________________________________________________________________________________________________________________________________________________ 20. Please comment on how well you feel the student met the goals contracted with you prior to the start of the internship. ____________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ Recommended Grade: Pass Fail Evaluator’s Signature____________________________________ Date_____________ Student’s Signature_____________________________________ Date:_____________ Return completed evaluation form to: Dr. James Wallace or Dr. Charles Eberly Department of Counseling and Student Development Eastern Illinois University 600 Lincoln Ave. Charleston, IL 61920      PAGE 1 Lvxƒ•–­ÇÈÙÚÛ  $ y « ± Â É Ê í ü ÿ  K L ¢ ã 2 · ì   È É Ì × æ ò þ Õ Ö Ø Ù æ "åæçéÿ-ïðñó÷ò÷òíòíòíéåéÞÚéÖåÖÒåÎåÎÒåÒéÒÊÒÊÆÂÆÂ¾å¾¹¾µ±µåµåµåµ±­©­¥­±©±å¥±­©­h»U¯hÅh ’hïuEh\`¦ h"lm5h"lmh´WqhwE¶hChºxhN±áåæ.³Ò±á¸éïð";<F÷÷òò÷êêâââÝÝââêêØØêêââÝÝâgdïuEgd ’dhgd ’dhgdïuEgd\`¦dhgd\`¦ó!áâäåç+íîïñ?.ðñòô"5:E   7ùúüþ?(0ñòôöØÚÜì°±³µÌ’”±stvxŽQSUber459X —5ÒüøüøôøüøðôøðìøôøìøìôøìèäèøôøäøäôøäøäøôøäàøÜôøàøôøàøðøØôøØøôøØøØôøØøôøÔðÔøÔôÐôÐôÐhí2}h5ÞhYéh{fÕh hXh…PhRh›xshÅh ’hÕ$ãPFãä,EFPíîAZ[e/HISðñG`ak 8QR÷÷÷òò÷÷÷÷òò÷÷÷òò÷÷÷÷òò÷÷÷÷òògd ’dhgd ’R\ùúAZ[e1JKUò/0:×Øí °±Îç÷÷÷÷òò÷÷÷÷òò÷÷÷òò÷÷÷÷òò÷÷÷÷ògd ’dhgd ’çèò²ËÌÖst©ª´QsŒ—45Zst~úòòòòúúòòòòúúòòòúúòòêêååêêgdÅdhgdÅdhgd ’gd ’˜5ÒÓó? ‹ ° Ø !%!7!L!N!O!Q!R!T!U!W!X!c!÷÷÷ïççß××ÒÒÒÒÒÐÐÐÐÐÐÐÐÈ$a$gd—i gd—i dàgdÅdàgd—i dhgdrðdhgdí2}dhgdÅÒÓòó - ¯ ° ´ Á × Ø L!M!O!P!R!S!U!V!X!Y!_!`!a!b!c!d!e!f!üøôøðôðôìðìðôäàäàäàäàÖÐÖÅÖôÁàôh®W©h{fÕ0JmHnHu h—i 0Jjh—i 0JUhãÞjhãÞUh›xshí2}h—i hÅhrðc!d!e!f!ýýøgd—i 21h:pô …°Ð/ °à=!° "° # $ %°°Ð°Ð Іœ@@ñÿ@ OG\NormalCJ_HaJmH sH tH DA@òÿ¡D Default Paragraph FontRióÿ³R  Table Normalö4Ö l4Öaö (kôÿÁ(No List4@ò4 —i Header  ÆàÀ!4 @4 —i Footer  ÆàÀ!.)@¢. —i Page Numberf8ÿÿÿÿMm–—­ÚÛLM¢£Ý 2Nlš› !+ÈÉ-.8ÕÖר$=>±áåæ.³Ò±á¸éïð";<Fãä, E F P í î A Z [ e  / H I S ð ñ G ` a k  8 Q R \ ù ú AZ[e1JKUò/0:×Øí °±Îçèò²ËÌÖst©ª´QsŒ—45Zst~˜5ÒÓó?‹°Ø %7LNOQRTUWXcg˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜@0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜0€€˜@0€€˜0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜0€€˜@0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜@0€€˜@0€€˜@0€€˜@0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€˜0€€hÎ007hŽ00¯hÎ007hŽ00¯hÎ00€hŽ00¯hÎ00€hŽ00¯@0€€hŽ00¯M !+ÈÉ-.8ÕÖ$=>±áåæ.³Ò±á¸éï";<Fãä, E F P î A Z [ e  / H I S ð G ` a k  8 Q R \ ù AZ[e1JKU/0:×Øí °Îçèò²ËÌÖs©ª´QsŒ—4Zst~˜5ÒghÎ00€hÎ00€hŽ00`%ÐhŽ00€hŽ00€hŽ00€˜0€€˜0€€hŽ00 œ7ÐhŽ00€hŽ00€˜0€€0˜@0€€hÎ00 ÐhÎ00€hÎ00€˜@0€€@0@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€@0@0@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€˜@0€€@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€˜@0€€@0@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€@0@0@0hÎ00 ÐhÎ00€hÎ00€˜@0€€hÎ00 ÐhÎ00€hÎ00€˜@0€€@0@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€˜@0€€@0@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€hŽ0\€@0hÎ00 ÐhÎ00€hÎ00€˜@0€€˜@0€€hÎ00 ÐhÎ00€hÎ00€˜@0€€@0hÎ00€hŽ0j0€˜@0€€˜0€€ óÒf!È FRçc!f!e! !ÿ•€ÿÿ лüïßÑ»äáKÒ»œ»ßÓ»LÃßÔ»”¬ßÕ»*€urn:schemas-microsoft-com:office:smarttags €PostalCode€9*€urn:schemas-microsoft-com:office:smarttags€State€:*€urn:schemas-microsoft-com:office:smarttags€Street€8*€urn:schemas-microsoft-com:office:smarttags€City€;*€urn:schemas-microsoft-com:office:smarttags€address€9 *€urn:schemas-microsoft-com:office:smarttags€place€= *€urn:schemas-microsoft-com:office:smarttags €PlaceType€= *€urn:schemas-microsoft-com:office:smarttags €PlaceName€ , Ô  QSLLNNOOQRTUWXdgQU|~LLNNOOQRTUWXdg3——ÇÈ$%%yy{{«±ÂÉíü33ÓìÌ׿òþ þÿì í ñ    TTñòPQbeÒÓóó,-??®¯°ØKLLNNOOQRTUWXbgUòQSLLNNOOQRTUWXdg5å4ihBCX …P—i ×/ 63ÒD>ïu·¡Æ%³Ò+²Ñ;3°¿¸é¢g±«ê`³Ý°¿³Ò°À–e±ðþ±ô"±ô³¾³Û´Ç±·þÿÿÿ@ABCDEFþÿÿÿHIJKLMNþÿÿÿýÿÿÿQþÿÿÿþÿÿÿþÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿRoot Entryÿÿÿÿÿÿÿÿ ÀF€“\GSEÇS€Data ÿÿÿÿÿÿÿÿÿÿÿÿ1Tableÿÿÿÿ%`2WordDocumentÿÿÿÿ48SummaryInformation(ÿÿÿÿÿÿÿÿÿÿÿÿ?DocumentSummaryInformation8ÿÿÿÿÿÿÿÿGCompObjÿÿÿÿÿÿÿÿÿÿÿÿqÿÿÿÿÿÿÿÿÿÿÿÿþÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿþÿ ÿÿÿÿ ÀFMicrosoft Office Word Document MSWordDocWord.Document.8ô9²q