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BTP Trainee Externship Evaluation

Page One

1. Trainee Name *This question is required.

2. Start Date *This question is required.

calendar

3. End date *This question is required.

calendar

4. Company Name *This question is required.

5. Company Address *This question is required.

6. Company contact (if other than supervisor) *This question is required.

7. Contact's email *This question is required. This question requires a valid email address.

8. Contact's phone This question requires a valid number format.

9. Externship Supervisor *This question is required.

10. Supervisor Title *This question is required.

11. Supervisor Telephone (include country code, if applicable) *This question is required.

12. Supervisor email *This question is required. This question requires a valid email address.

13. This externship was *This question is required.

14. Please indicate your reason(s) for selecting this company. *This question is required.

15. Evaluation of externship components

Space Cell	Exceptional	Above Average	Average	Poor	Below Average
Supervision
Science
Lab culture/atmosphere
Teaching/learning environment

16. Briefly describe your project *This question is required.

17. Briefly describe what you learned (i.e., techniques, culture of non-academic setting, etc.). *This question is required.

18. Would you recommend this company to others?

19. Additional Comments

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