Placement Host Assessment Form

Loyalist College Protection, Security & Investigations Work Placement Evaluation
To be completed by Placement Host Agency by Friday at end of Week 4
Date Completed*
MonthDayYear
Is your workplace covered by WSIB?*
YesNo
Company Name/Organization*
Student' Full Name*
First NameLast Name
Placement Host - Name of Assessor*
Assessor E-mail*
Assessor Phone Number*
Area CodePhone Number
Total Number of Hours Worked (140 Hours is optimum or 35 hours per week)requested*
Student Work Schedule Each Day (Required for WSIB or Private Insurance)*
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
1
2
3
4

Please rate the students attributes in the following areas:*

	Poor	Average	Very Good	Excellent	Not Applicable
1.Deportment & Punctuality
2.Initiative & Drive
3.Inquisitiveness(Enthusiasm)
4.Team Work-Ability to work with others
5.Attitude towards Superiors & Public

Please provide important feedback for both the student and the teacher on the ratings given for attributes 1 to 5 inclusive (listed above)
Attribute #1 - Deportment & Punctuality*
Attribute #2 - Initiative & Drive*
Attribute #3 - Inquisitiveness (Enthusiasm)*
Attribute #4 - Team Work (Ability to work with others)*
Attribute #5 - Attitude towards Superiors and Public)*

Please rate the students attributes in the following areas:*

	Poor	Average	Very Good	Excellent	Not Applicable
6.Job Knowledge or related skills
7.Oral Communication Skills
8.Written Communication Skills
9.Use & Application of Technology
10.General Aptitude for employment or career

Please provide important feedback for both the student and the teacher on the ratings given for attributes 6 to 10 inclusive
Attribute #6 - Job Knowledge or related skills*
Attribute #7 - Oral Communication Skills*
Attribute #8 - Written Communication Skills*
Attribute #9 - Use & Application of Technology*
Attribute #10 - General Aptitude for employment career*
YOUR FEEDBACK ON LOYALIST COLLEGE - PSI PROGRAM & PLACEMENT
From your observations and feedback from staff/co-workers,do you have any suggestions that might help to strengthen the PSI program and/or placement
If you have any questions at all or wish to follow up further, please contact:

Kevin Rowcliffe or Tracy Mackenzie
Professors & Co-Coordinators
Protection, Security & Investigations Program
School of Justice Studies
Loyalist College
(613)969-1913 Ext. 2387
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Should be Empty: