Undergraduate Classwork & Field Evaluation Form

FIELD WORK PERFORMANCE
Please describe the level of practice developed by the student in work with individuals, families, groups and/or communities.
Identify specific skills required for further development, and specific lack of skills reflected in pronounced learning gaps. Brief
illustrations from junior and/or senior year assignments would be appreciated.
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JOB MANAGEMENT
Please describe the student’s capacity to handle workload (recording, reports, use of time, etc.)
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FIELD INSTRUCTION
Supervision Junior Year Senior Year
Was the student supervised by an MSW yes no yes no
Was the student supervised individually yes no yes no
How often was the student supervised weekly bi-monthly weekly bi-monthly
Other (explain) _________________________________________________________________________________
Process Recordings
Required yes no yes no
If no, describe __________________________________________________________________________________
AGENCY EVALUATION
Was there a written evaluation at the end of each
semester or at the end of the academic year semester year
Did the student read and agree with the final evaluation yes no
ACADEMIC PERFORMANCE
Please comment on the applicant’s academic performance, intellectual capacity, ability to think logically and clearly and ability to
integrate theory and practice.
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SUMMARY:
Taking all of the above into consideration, do you think the applicant is capable of functioning at the beginning third semester
graduate level
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Signature _____________________________________________________
Date _________________________________
Please return to applicant in a sealed envelope with your signature across the back flap.
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