Supervisor Assessment Form

Publisher: Center for Civic Engagement, KVCC (Kalamazoo Valley Community College)

The Supervisor Assessment Form is a service-learning evaluation template used by KVCC’s Center for Civic Engagement. A field supervisor at a student’s service-learning site fills it out to rate the student’s performance for a course.

It collects basic identifying information: student name, service-learning site, supervisor’s name and contact info, the course number, and the instructor’s name.

The rating section covers nine performance areas, each scored on a 1 to 5 scale from Excellent to Poor:

  • Ability to work with minimal supervision
  • Follows directions
  • Punctuality
  • Quality of work
  • Relationship with clients and customers
  • Sense of responsibility
  • Shows interest
  • Uses good judgment
  • Willingness to learn

There’s an open comments section for additional notes, followed by a signature and date line for the supervisor to complete the form.