Co-op Work Experience Report
Please complete this form to report on your co-op work experience. Your responses help us evaluate and improve the co-op program.
Student Name
*
First Name
Last Name
Student Email Address
*
example@example.com
Employer / Company Name
*
Position / Job Title
*
Work Experience Period
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Briefly describe your main duties and responsibilities during your co-op placement.
*
What skills or knowledge did you gain or improve during your co-op experience?
*
Supervisor Name
First Name
Last Name
Supervisor Email (if known)
example@example.com
Would you recommend this co-op placement to other students?
*
Yes
No
Not Sure
Submit Report
Should be Empty: