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?
Company Name/Organization
Student' Full Name
First NameLast Name
Placement Host - Name of Assessor
Assessor E-mail
example@example.com
Assessor Phone Number
Format: (000) 000-0000.
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)
Rows Monday Tuesday Wednesday Thursday Friday Saturday Sunday
1
2
3
4

Please rate the students attributes in the following areas:

Rows	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:

Rows	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 Cell:(613)885-2968 or Tracy Mackenzie Cell: (613)453-6408
Professors
Protection, Security & Investigations Program
School of Justice Studies
Loyalist College
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Loyalist College Protection, Security & Investigations Work Placement Evaluation