NHS Internship Program

380 Elm Street

Northampton, MA 01060
(413) 587-1332

Monthly Report for: __________________________ __________________________

(Student Name) (Month and Year)

Overall Objectives of the program which the mentor will evaluate the student.
(Please use the following key):

1= Consistently 2= Frequently 3= Inconsistently 4=Rarely 5= Not Yet N/A= Not Applicable

JOB SEEKING
1. Student can apply basic academic skills to workplace
2. Student plans and prepares for current and future career options based on personal qualities and
interests

JOB GETTING
1. Student demonstrates a positive work ethic
2. Student exhibits ability to adapt, cope, and change
3.Student understands the need to maintain physical and mental health and fitness necessary to perform in
the workplace

4. Student selects, applies, and maintains tools and technologies when needed
5. Student identifies the need for continued learning
JOB KEEPING
1. Student listens effectively
2. Student communicates effectively
3. Student prioritizes time
4. Student gathers, interprets, and evaluates information
5. Student maintains positive attitude
6. Student participates effectively in production work groups
7. Student works in harmony with culturally diverse workforce and community
8. Student plans activities to meet goals and objectives
9. Student maintains a safe and healthy work environment
10. Student produces expected quality and quantity of work
11. Student demonstrates ability to generate innovative and practical solutions
12. Student is developing positive customer/client relationships
13. Student is reliable and never/seldom late

Additional comments: ____________________________________________________________________

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Student Signature:____________________________ Mentor Signature:____________________________

Mentors must submit Monthly Reports evaluating students overall performance based on above criteria and
contracted objectives and requirements. Reports are due by the last day of each month.