Employer Interim Extension Evaluation Form

Instructions:

Federal regulations require all host companies complete an Interim Extension Evaluation at the midpoint of the Trainee/Intern's extension period. The purpose of this evaluation form is to provide the Trainee/Intern with feedback concerning his or her personal progress in meeting their goals at the midpoint of their extension period, as outlined in the Training/Internship Placement Plan submitted with the extension application. Please complete this evaluation at the midpoint of the participant's extension period and share your comments with the participant before submitting the evaluation to InterExchange. Thank you.

Fields marked with an asterisk (*) are required.

Trainee/Intern Name:*(Required)
Host Employer:*(Required)
Supervisor Name:*(Required)
Department:*(Required)
Please describe how training during the extension period has built upon the original Training/Internship Placement Plan i.e. what tasks has the Trainee/Intern performed during the extension period that built upon skills learned during the original training period? *(Required)
Has the Trainee/Intern had any difficulties with the more advanced level of training performed during the extension period? *(Required)
Please describe any special training (seminars, conferences, on-the-job training, research) that the Trainee/Intern undertook to reach a more advanced level during the extension period. *(Required)
Are there specific areas of improvement that the Trainee/Intern should focus on for the remainder of the extension period? *(Required)

InterExchange : Career Training USA

Employer Interim Extension Evaluation Form

Instructions:

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