t -a-,l /ytg:p"t3!sfADEEDtrt ll, h L.rr

t\ettrcesL.at.ins For Lif. Form

Student's Name:

Program: Cl9 -

This Evaluation is

Student lD No:

Mo./Yr. of Graduation:

Based on Course(s):

StudentReference

Dales Attended i\.4STC: Fro/n Imonth &.yeaf):. T5.IUA.i 2OuZ to (month & year): N\\ 2-Ot,<

rnstructor's sisn^tur" )//^),- u/;'-/..l'-

oate {r/zo,/O? "

working Producti Assurinq QualityAn individual possesses and applies elfeclive work habiis and altiludes wilhin anorgan,zal.onal lclassroom, lab. or shop) senrng.

Rating2 1 N

1. Manages time and wcrk lcaC (assign$enls, prcjects) V/2. Follows salety procedures / rules l-,'3. Handles responsibillty in a dependable manner l-/4- Carries out instruclions

Learnin EfrectivelyAn individual possesses necessary basic skills ln reading, writing. and compuling;applies skills in acquiring iniormation; and uses learning tools and siIategies.

2- Uses learning resources

3. Organizes iniomation

CommunicatingRalingAn individual is able to aPPIY

precisely convey inlormalion,appropriate writing, speaking,ideas, and opinions.

and lislening skills in order lo

1 Apples lhe Engllsh language correcly (sPelling, gammar, slruclure)

2 Speaks underslandably

3. Wriles undersiandably

4 Demonslrales abilty to ljslen ellecljvely

5 Uses anguaqe aPp,oPaare Io siluatron

Working Cooperativelyian rrcrv,cual is capablo ol working wrll cthels lo compl€ts lasks'

.. re . ! e'!::. '"s.1"€ ..n!l:.::. iI.\.":e :.1.=?!!^"nc ^fiE' SUFPO'I

1. ' ro"s coop€'"trvsly wilh oth€rc (classroom, shop, P6cticing)

IIEfi on"lrates ,."p.a lor others through word and aclion

3. Provid€s and eccepts loedbacl(

An individual rscognEes an obligation to sell and others lor his or h6r decisions and actions'

1. At!6nds class regularly and punctually

I-7IL:mes resPonsioitity ror compleling assignments

3. Psdorms assigned tasks

ifT-*s procuctivety and stays on task

Comment3:

Comments:

An individuat uses lhe Principles ol science and recognizes the impacl o' iechnology'

[monstratestechnologicalliteracy

Comments:

Demonstrating A-'riareness

ffirgroup behaviors in cross- cuttulal

i"i"i""i,""" ""a "tet*

social intelaclion in a lartetv ol snualions

1. Fespecls cullural dilJerences

ft6iliiii"at"" in , cullurallv sensilive manner

(print nahe olclassroom and/or

Studeni's Signatu

Please return comPleled form lo:' '- tl,o-State lecnnlcal College Career Servrces Olfce'

Phcne NLrmber: (715't 422-5445 ot O15') 422'5362

E.Marl: careerservices@midstate tec'wi us'

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FAX Number: c/15) 422-5440

Web Page Address: www.midstate'tec'wl us

Mid-State Technicat Coltege is An Equat opportu;ity/Affirmative Action Educator and EmployeL