Immersion Supervisor Evaluation Form Program Waiver

IMMERSION SUPERVISOR EVALUATION
Name of Student: ___________________________________________________________

Cooperating Firm: __________________________________________________________
Period Covered: ___________________________________________________________
TO THE SUPERVISOR: In each category, please put a check (√) mark beside the phrase
which best describes the student-trainee.
ABILITY TO FOLLOW INSTRUCTION COOPERATION

_____1. Uses initiative in interpreting and _____1. Always cooperate eagerly and
following instructions cheerfully
_____2. Usually follows instructions with no _____2. Usually cooperates eagerly and
difficulty Cheerfully
_____3. Follows instructions with some difficulty _____3. Cooperates willingly when asked
_____4. Needs repeated detailed instruction _____4. Cooperates reluctantly
APPEARANCE PUBLIC RELATIONS

_____1. Exceptionally neat and appropriately _____1. Extremely tactful and understanding
dressed in dealing with others
_____2. Neat and appropriately dressed _____2. Usually poised, courteous, and tactful
_____3. Satisfactory appearance and dress _____3. Tries to please others
_____4. Sometimes neglectful of appearance _____4. Sometimes lacks poise and seem
indifferent to others
ATTITUDE TOWARD WORK DEPENDABILITY

_____1. Takes a keen interest in the training and _____1. Meets all obligations and unfailingly
takes initiative to learn without supervision
_____2. Shows interest or enthusiasm for the _____2. Meets obligations with very little
training supervision
_____3. Shows little interest or enthusiasm for _____3. Meets obligations under careful
the training supervision
_____4. Has some interest in the training _____4. Sometimes fails in obligation even
under careful supervision
ATTENDANCE AND PUNCTUALITY EXPENSE CONSCIOUS (Materials and

Equipment)
_____1. Never absent or late without good cause _____1. Extremely careful in using materials
and equipment
_____2. Seldom absent or late without good _____2. Uses good judgment in using
cause materials and equipment
_____3. Occasionally absent or late _____3. Takes average care in using materials
and equipment
_____4. Frequently absent or late _____4. Careless about materials and
equipment
Page 2 – EVALUATION
SPEED OF WORK WORK AREA

_____1. Finishes assigned tasks ahead of _____1. Keeps work area outstandingly neat
schedule and efficiently organized
_____2. Jobs are usually completed on time _____2. Takes pride in appearance and
arrangement or work area
_____3. Takes a little extra time to finish the job _____3. Follows good housekeeping rules
_____4. Very slow worker _____4. Allows work area to be disorganized
and untidy
OBSERVANCE OF COMPANY RULES JOB SKILLS

_____1. Always observes company rules _____1. Possesses all the essential skills and
related information
_____2. Seldom disregards company rules _____2. Has an above-average command of
the essential skills and related
information
_____3. Observes most of the company rules _____3. Has an acceptable command of the
skills and related information
_____4. Frequently neglects company rules _____4. Lacks in the essential skills and
related information
QUALITY OF WORK OVERALL EVALUATION OF STUDENT

TRAINEE
_____1. Has the aptitude for doing neat, _____1. Outstanding
accurate work and exceeding the _____2. Above Average
requirements _____3. Average
_____2. Does more than the required amount of _____4. Poor
neat, accurate work
_____3. Does the normal amount of acceptable
work
_____4. Does less than the required amount of
satisfactory work
___________________________________________
Printed Name and Signature of Immersion Supervisor
Date of Evaluation: _____
NOTE: 1. Please provide additional comments you wish to make on the space provided below or in
an extra sheet. Information particularly on deficiencies in the theory and skills aspect of
our students will be very helpful.
2. Return to us in a sealed self-addressed envelope with your signature on the flap.
IMMERSION PROGRAM
WAIVER
For and in consideration of the Immersion Program, an integral part of the Science,
Technology, Engineering, and Mathematics (STEM) Academic Track offered by the College
of Education – Integrated Development School (CED – IDS), I,
_____________________________________________, hereby voluntarily agree to undergo
(Name of trainee)
an Immersion at the __________________________________________________, located
in
(Name of Office/Agency)
______________________________________________ for the duration of eighty (80)
hours
(Address of Office/Agency)
from _____________________, _______. In connection with the aforementioned program, I,
(Start Date)
together with my parents/guardian, hereby agree to the following terms and conditions, to
wit:
i. That the agency will not be liable for any untoward incident that may happen while
on my way to and from the training site and in the performance of my duties and
functions as a trainee;
ii. That I shall abide by the agency’s rules and regulations;
iii. That I shall exercise care and diligence in any task assigned to me;
iv. That I shall be made liable for the damages to the property, equipment, and/or injury
on the third person, which may occur by any intentional and/or negligent act while in
the course of training; and
v. That I shall not receive any remuneration and incentive of any form accorded to the
regular/casual employee of the ______________________________________.
Signed this ______ day of ___________________, 2024 at the

__________________________________________________________.
___________________________________ ______________________________
(Signature over Printed Name of Immersion participant) (Signature over Printed Name of parent/guardian)
Witnessed:
__________________________________ _____________________________
(Signature over Printed Name of Immersion Coordinator) (Signature over Printed Name of Company
Representative)
________________________________
(Name of Company)

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IMMERSION SUPERVISOR EVALUATION

Name of Student: ___________________________________________________________

ABILITY TO FOLLOW INSTRUCTION COOPERATION

APPEARANCE PUBLIC RELATIONS

ATTITUDE TOWARD WORK DEPENDABILITY

ATTENDANCE AND PUNCTUALITY EXPENSE CONSCIOUS (Materials and

SPEED OF WORK WORK AREA

OBSERVANCE OF COMPANY RULES JOB SKILLS

QUALITY OF WORK OVERALL EVALUATION OF STUDENT

Date of Evaluation: _____

Signed this day of _____________, 2024 at the

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