HOST EVALUATION

Dear Host Supervisor:

Thank you for hosting a J-1 Exchange Visitor Program Participant!

Please share your observations on the participant’s development in the internship or training program at your organization. We encourage you to read the participant’s Training/Internship Placement Plan (DS-7002) and discuss your observations with him or her before completing this form. Your feedback is essential for the participant’s learning progress and improving skills.

Please feel free to contact us if you have any questions or would like to discuss the participant’s progress or concerns. Your feedback and involvement in the program is essential to its success.

Thank you for providing continuous supervision and leadership the J-1 Exchange Program Participant!

Date*

Date

The Intern / Trainee's Name*

First NameLast Name

Is that person an Intern or a Trainee?*

InternTraineeNot sure

Your Name (person filling out this form)*

First NameLast Name

Host Organization Name*

Is this a midpoint evaluation or a final evaluation?*

MidpointFinal

Please rate your intern/trainee*

	Very Good	Good	Average	Unacceptable
The participant’s overall professionalism
The participant's willingness to follow directions and/or suggestions
The participant's ability to complete tasks and positively contribute to your organization
The participant's English speaking ability
The participant's English writing ability

If you rated the participant as "Unacceptable," please provide more context below:

Do you or your colleagues encourage the participant to take part in cultural activities outside of their training?*

YesNo

Please describe below any cultural activities that have been encouraged or arranged for the Intern / Trainee

Has your organization benefited from hosting an international Intern / Trainee?

Are you satisfied with the level of support you received from the program sponsor, ICLS?

Host Signature*

HOST EVALUATION

Intern / Trainee's Professional Development

Intern / Trainee's Cultural Experience