Student Co-op Evaluation Form

Fields marked with * are required
* First Name
* Last Name
* Stout ID
Stout Mentor

* Company Name
* Company Location State: City: Zip:

* Co-op Position Title
Dates of Co-op Assignment Begin date: End date: (mm/dd/yy)
Avg. work hour per week
Pay rate/Hr
If you received a pay increase, please provide your highest salary. Also, if you were being paid in increments other than hourly, please divide the money made by the hours worked and enter the hourly rate.

1. How valuable was this work experience to you in: Rate on a scale of 1-5 : (1=no value) : (5=very valuable) : (NA=No Answer)
Helping you decide on your future career (in this area or a different area)?
Providing insight into your employer's business or operation?
Learning new skills or techniques?
Clarifying your future educational goals?
Applying, integrating, or making relevant knowledge gained from your courses?

2. Did you receive a job offer for a permanent position after graduation from your co-op employer?: Yes No
3. Did you accept the permanent job offer? Yes No
4. Who is your permanent job employer (company name)
5. What is your new job title?
6. Indicate what you feel are the strong points or highlights of your work experience at your company.
7. Indicate changes that would have made your work experience more meaningful.
8. In what way(s) was this work assignment meaningful to your academic program?
9. Do you feel a student should possess any special qualifications or requirements for this assignment? Yes No
If yes, please explain:
10. Did you receive enough assistance from your work site supervisor? Yes No
If no, how could he/she have helped more?
11. Would you recommend this employer for future Co-ops? Yes No
If no, please explain:
12. Other remarks?