FACULTY ON-SITE VISIT REPORT FORM

FACULTY ON-SITE VISIT REPORT FORM
Student Name:
Discipline:
Company Name:
Company Address:
Company Telephone:
Date of Visit:
Time of Visit:
Visitor’s Name:

Student Name:
Discipline:
Work Term No.: 1 2 3 4 5 6 Extended Term (8 mo.):
Previous Work Terms:
WT 1
WT4
WT 2 WT 5
WT 3 WT 6
Term Faculty Advisor:
Format:
In person visit Telephone
Company:
Supervisor’s Name:
Supervisor’s Title:
Supervisor’s Phone Number:
Student’s Phone Number:
Discussion with Employer
Ask the employer to discuss the student’s performance, preparedness for the placement and any feedback
on problems or concerns that they have. You may wish to touch on the following areas:
• An overview of the students projects and responsibilities
• The student’s ability to learn and apply technical skills
• The student’s ability to solve problems independently and to work as part of a team
• The student’s social skills, character and attitude
• The student’s research abilities, written and oral communication skills
• The student’s learning objectives
• The student’s time management and organization skills
• The employer’s overall impression of the student
• The employer’s overall impression of the Co-op program and potential for future placements
• Possible collaborative projects between the university and the employer
Discussion with Student
Ask the student to discuss their work to date, what they have learned, whether their expectations for the
placement are being met, and any problems or concerns that they have. Review the student’s learning
objectives. You may wish to touch on the following questions:
• What skills and knowledge have you gained so far? Have you felt challenged with the work you are
doing? Has the work you’ve been doing correspond to the job posted with the Co-op office?
• What connections do you see between this work and your studies at UBC?
• Are you receiving supervision and feedback on your work? Are your working conditions
productive?
• Do you feel there is successful communication between you and your supervisor?
• How are you enjoying your work term so far?
• At what stage is your work term report? Will it be: Confidential Non-Confidential
• What skills or areas do you wish to improve? How could you improve your performance?

EMPLOYER NOTES:
STUDENT NOTES:

ACTION ITEMS:
Signature:
Date: