FORM C

English Version

INDUSTRIAL TRAINING UNIT

CONFIDENTIAL
FORM C (30%)
INDUSTRIAL SUPERVISORS REPORT
Students Name
ID No.
Course
Organisations Name
Duration of Training
Reminder:

Please return this form to University Supervisor in final week of

intership in a sealed envelope:Unit Latihan Industri
Jabatan Hal Ehwal Akademik & Antarabangsa
Universiti Malaysia Pahang
Lebuhraya Tun Razak
26300 Kuantan Pahang
Malaysia

For Industrial Supervisor. Total mark for Intern Performance Evaluation is

Total Mark X 30 =

/30
60

Intern Performance Evaluation

Instructions:

1/3

FORM C
Supervisor is kindly requested to fill up (/) the box indicated on each item in section A and
B as guideline shown below:1= Not Satisfied
2= Less Satisfied
3= Satisfied

4= Good
5= Very Good

Section A (Job Performance)

5
A.1

Knowledge about the task assigned:

In-depth knowledge about area of work.

A.2

Job production:
Quality of job evaluated against professional
standard.

A.3

Quality of job performed:

Precision and efficiency.

A.4

Punctuality in production:
Ability to carry out job within the specified time
frame.

A.5

Initiative:
Ability to act independently in accomplishing
the tasks assigned and solving problems.

Section B (Interns Soft Skills)

5
B.1

Dedication:
Positive attitude and work dedication.

B.2

Cooperation:
Associate himself with others in carrying out
job.

B.3

Discipline:
Willingness to conform to organisations rule.

B.4

Responsibility:
Honest, sincere, fair and caring attitude to
others during the training.

B.5

Socialization:
Ability to socialize with different levels of staff
in the organization.

B.6

Communication:
Ability to express ideas and orders in a clear
and organized manner.

B.7

Decision making capability:

Ability to make decision in achieving the goals
2/3

FORM C
that have been set.

Section C (Interns potential in the profession and overall comments)

(Supervisor is kindly requested to write up comments on intern's potential and overall
comment)
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.........................................................................................................

Will your organisation offer this intern a job?

No

Yes

.........................................................
Supervisors signature
Name

: .....................................................................................

Position & Chop

: .....................................................................................

Professional Title

: I.R / Dr. / etc. Please specify .: ..................................

Date

: .....................................................................................

3/3