Mid-point Evaluation/Host





Host Organization

Name of Intern/Trainee

Name of Supervisor

Your Email

The Intern/Trainee seems to be adjusting well to the American culture and way of life:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The Intern/Trainee behaves in a professional manner:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The training plan (DS-7002) is being followed:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The Intern/Trainee is making progress:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The Intern/Trainee shows interest in his/her assignments:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The Intern/Trainee is receptive to feedback:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The Intern's/Trainee's performance is satisfactory to date:
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

I (the Supervisor) have the following confidential comments:

Please contribute with a short testimonial that highlight's how satisfied you are
with your trainee's performance and the SACC-USA Trainee Program, which
can be used in promotional purpose (optional):

Submitted by:

Date