Field Practicum Evaluation Final Student Section

The standard by which an intern is to be compared is that of a new beginning-level social worker. The 9 competencies specified in this evaluation form are those established by our national accrediting organization (the Council on Social Work Education). Under each competency statement are several items that we ask you to rate according to the following criteria.

Name*
First Last
Student Intern's Email*
Date*
MM slash DD slash YYYY
Intern Section
The following section should be completed by the Intern.
Intern Name
Agency Name
Date*
MM slash DD slash YYYY
Untitled*
- I agree with the evaluation.
- I disagree with the evaluation.
My Field Supervisor and Field Coordinator have discussed this evaluation with me, and I have received a copy. My agreement or disagreement follows.
Disagreement Explained
Intern's Signature

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Field Practicum Evaluation Final Student Section

Field Practicum Evaluation Final Student Section

Intern Section