FORM A: Performance Appraisal Form

(To be filled by the Supervisor of the Participated Organisation)

Universiti Selangor
Faculty of Education and Social Science

Student’s Name: _ _ _ _ _ Date of Evaluation : _ _ _ _ _

Date Commence: __ _ _E_n_d_ _______ Department : _ _ _ __

Job Title: ______________________________ Organisation’s :_ _ _ _ _

Supervisor Name
SECTION A: STUDENT’S PERFORMANCE
Please consider the individual’s demonstrated performance and mark the circle most closely describes that
performance.
5 – Exceptional: Performance consistently far exceeds expectations and is superior to the vast
majority of employees.
4 – Very good: Performance consistently exceeds expectations and job requirements.
3 – Good: Performance consistently meets expectations and job requirements.
2 – Acceptable: Performance usually meets expectations and minimum requirements for the job.
1 – Unacceptable: Performance is below minimum acceptable level.

1. WORK QUALITY: The reliability, accuracy and neatness of work produced.

1 2 3 4 5

2. WORK VOLUME: The amount or volume of work accomplished.

1 2 3 4 5

3. DECISION MAKING: The ability to make well-reasoned decisions, which affect work performance.
1 2 3 4 5

4. INITIATIVE: The willingness to extend oneself to complete assigned tasks.

1 2 3 4 5

5. TEAMWORK: The working relationship with employees in the working environment.

1 2 3 4 5

6. RELIABILITY: The reliance, which, can be placed on the student to persevere and carry through to completion
any task assigned. Also applies to attendance.
1 2 3 4 5

7. CREATIVITY: The idea generated during the task assigned.

1 2 3 4 5

8. PARTICIPATION: The contribution and involvement during the industrial training.

1 2 3 4 5

9. DATELINE ADHERENCE: Meeting all the dates given.

1 2 3 4 5

10. APPLICATION OF THEORY: How well the student applies all the theoretical knowledge into practical.
1 2 3 4 5
11. If you have the opportunity, would you like to recruit him/her?
Yes No

12. Please rank the following aspects base on what your organization believes as the most important:
(1 as the most important and 3 least important)

Personality

Wellbeing

Commitment

SECTION B: SUPERVISOR’S GENERAL COMMENTS

1. Have the trainee met your expectations? Please explain briefly.

2. What are areas of improvements that you would suggest for the trainee?

3. In future, would you accept students as trainees from Universiti Selangor? Please indicate the
number of students required in future.
 SECTION C: EVALUATION

Marks Allocations:

Total point Q1 – Q10 from Section A = / 50

Overall Evaluation = Pass (18 – 35 point)

Fail (0 – 17 point)

Supervisor’s :
Signature

Designation :
Company’s Stamp

Note: The supervisor may choose to review this performance appraisal with the student. However, the Marks
Allocations in the Section C must not be disclosed to the student.

…………………………………………………………………………………………………………..
Please email or post this performance evaluation immediately after the student finishes
his/her industrial training session to:

Teaching Practice and Industrial Training Unit

Faculty of Education and Social Sciences
Universiti Selangor
Jalan Timur Tambahan, 45600 Bestari Jaya
Selangor Darul Ehsan

email: praktikum_fpss@unisel.edu.my