Exercise Science Student Practicum Evaluation Form

This form is to be used for practicum mentors for student evaluation.

Please rate Please rate the student (1-5) in the following areas. Your feedback is greatly appreciated.

5 = Always,  4 = Most of the time,  3 = Sometimes,  2 = Rarely,  1= Never 

Student communicates effectively with the staff & the public.
Student acts & dresses appropriately & professionally.
Student is a good listener and asks good questions of the mentor.
Student is responsible, reliable and shows up on time.
Student shows enthusiasm towards the practicum.
Student has an adequate knowledge base for the practicum.
Student is respectful of the staff and the public
Student shows initiative and creativity.
Student showed significant effort to learn from you
Student represented COCC in a positive manner.
What over-all grade would you give the student for their practicum?
Signature of practicum mentor:  by checking this box I agree that this information is accurate to the best of my knowledge.


If you have questions please contact:
John Liccardo, M.S.
Assistant Professor
Health and Human Performance
Central Oregon Community College
206H Mazama Hall
2600 College Way
Bend, OR 97703