Student Work Report Form

This form provides Career Services with information regarding your internship. Please submit one week prior to completion of your work assignment.

You will receive a copy of this form via email if you specify your email address below.*
Your supervisor WILL NOT receive a copy of this form.

First Name:	Middle Name:	Last Name:

Current School Address:
*Email Address: (a copy of this form will be sent to this email address)	UT ID#:
Current Major:	Expected Grad Date:
Current Work Semester: Fall Spring Summer	Year in School: Sophomore Junior Senior
Employment Information
Employer Name:	Location (City/State):
Salary: Hourly or Monthly (Net--Before taxes salary)
Supervisor's Name:	Title:
Supervisor's Phone: (include area code)	E-mail:
Student Work Report
Housing Allowance: YES NO If YES, Amount:	Relocation Stipend: YES NO If YES, Amount:
Describe your major reponsibilities and duties:
Did you attend an orientaion and/or training session(s)? YES NO
Did you have any special projects? YES NO If YES, please describe:
Did you make a formal presentation? YES NO
What were the most significant things you learned?
Would you recommend this employer for other students in your major? YES NO
Would you recommend this employer for students in other majors? YES NO If YES, what majors?
Was the Supervisor's Evaluation discussed with you? YES NO
Did you discuss your views of the work assignment and/or your performance with your supervisor? YES NO
All things considered, how would you rate this internship assignment? Excellent Very Good Good Adequate Poor
How would you rate your overall effort for this internship? Excellent Very Good Good Adequate Poor





	Need additional information? Contact: DeAnna Bonner · (865)974-5435 · (865)974-6497 (fax) For technical difficulties with this site, contact Career Services WebMaster: career@utk.edu Copyright ©2003 The University of Tennessee · Knoxville Tennessee 37996

Employment Information