Professional Documents
Culture Documents
Madam or Sir,
You have welcomed an intern from the University of Rouen and we thank you for that. In order to evaluate
this training period in a professional context, and in line with the article n12 of the agreement, we would
be grateful if you could fill in the following document and send it back to the students supervisor.
INTERN
Name Surname Date of birth
day / month / year
Degree Year
Tittle of the degree
Supervisor
E-mail
WELCOMING STRUCTURE
Name of the structure
Address
INTERNSHIP
Type of the internship : Mandatory Non Mandatory duration
Specify the number of weeks or months
Object of the internship :
Date : From to
day / month / year day / month / year
1/3
Direction des Enseignements et du suivi des Parcours tudiants
Bureau dAide lInsertion Professionnelle
24 bis rue Jacques Boutrolle dEstaimbuc - 76821 Mont Saint Aignan cedex
INTERNSHIP EVALUATION
d
pe
d
elo
ate
g
din
og
ev
lu
va
go
ed
n
sta
te
ry
b
o
ir
Go
Ou
No
Professionnal integration
Ve
Fa
To
General interest shown for the host structure and positions
Ponctuality
Ability to interact
Organisation skills
Autonomy
Professionnal skills
Ability to summarize
Oral skills
Writing skills
Remarks
2/3
Direction des Enseignements et du suivi des Parcours tudiants
Bureau dAide lInsertion Professionnelle
24 bis rue Jacques Boutrolle dEstaimbuc 76821 Mont Saint Aignan cedex
GENERAL EVALUATION
Yes No Partially
3/3
Direction des Enseignements et du suivi des Parcours tudiants
Bureau dAide lInsertion Professionnelle
24 bis rue Jacques Boutrolle dEstaimbuc 76821 Mont Saint Aignan cedex