FORM C

English Version

INDUSTRIAL TRAINING UNIT

CONFIDENTIAL
FORM C (30%)

INDUSTRIAL SUPERVISOR’S REPORT

Student’s Name Mohammedi Yunus Bin Mohammedi Ahmed

ID No. MA20143

Course Sarjana Muda Kejuruteraan Mekanikal Dengan Kepujian

Organisation’s Name SAM Engineering And Equipment

Duration of Training 10 Weeks

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

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 FORM C

Intern Performance Evaluation

Instructions:

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 4= Good

2= Less Satisfied 5= Very Good
3= Satisfied

Section A (Job Performance)

1 2 3 4 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 (Intern’s Soft Skills)

1 2 3 4 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 organisation’s 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.

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 FORM C

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
that have been set.

Section C (Intern’s potential in the profession and overall comments)

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

comment)

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Will your organisation offer this intern a job? Yes No

.........................................................
Supervisor’s signature

Name : .....................................................................................

Position & Chop : .....................................................................................

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

Date : .....................................................................................

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