ࡱ> Yhc#` 0bjbj 8@nnnnD AAAA A`>TBBBBBCCChMjMjMjM5MPS$4UhWJSGC"CGGSnnBB%SGGGG"nRBBhMGGhMGGI"JBB HmpXA'G.ITI,WUG(WJJWJ$CvqDTGDD ECCCSS}GCCC>TGGGG```D*```D* nnnnnn  IUP SAFETY SCIENCES CO-OP EVALUATION FORM ___________________ ________________ Name of Student Dates at Site Name of Organization I. Professional Performance a. Did the co-op student attend regularly? Yes No_____ b. Did the co-op student utilize their time effectively? Yes No_____ c. Did the co-op student act in a professional manner? Yes No_____ d. Did the co-op student act in an ethical manner? Yes No_____ II. Academic Performance (Place "X" as appropriate and provide additional comments on back if desired.) OutstandingExcellentAbove AverageAverageBelow AverageUnsatis-factoryNot ObservedKnowledge of Occupational Safety and Health       General Application of Knowledge       Communication Skills (Written)       Communication Skills (Oral)       Interpersonal Skills Interacts well with individuals at all levelsLeadership Skills (ability to plan, organize and implement)       Ability to analyze and interpret accident and exposure data       Ability to recognize and evaluate hazards and develop controls       Grade Equivalent A+ A B C D F -Points Value 100 95 85 75 65 55 - III. Was the co-op program administered in a professional manner? Yes No__________ IV. Would your organization be willing to participate again? Yes No__________ Signature_____________________________________________ Date______________________ Please return this form to: Co-op Coordinator Department of Safety Sciences ϳԹ 1010 Oakland Avenue Indiana, PA 15705-1087 or fax to: 724-357-3992 -r$ - 7 A H I    H Q [ l m  GL`nr۫h~6CJOJQJ]h.wjh~Uh~5CJOJQJh~>*CJOJQJaJh~CJOJQJaJh~h~>*CJOJQJh~5>*OJQJ\h~CJOJQJ5-.I  m   $ 1 :$G$If dO$If`gd~ `0^`0gd~gd~gd~ Hgd~1 2 ^ _ ` a C9090 du$If :$G$Ifkd$$Ifִ t"& 88    44 aa b c d e f g h i j k l du$If :$G$If l m C9090 du$If :$G$Ifkd$$Ifִ t"& 88    44 a du$If :$G$If C9090 du$If :$G$Ifkd$$$Ifִ t"& 88    44 a du$If :$G$If C9090 du$If :$G$Ifkd6$$Ifִ t"& 88    44 a du$If :$G$If ; < = > C9... du$G$If :$G$IfkdH$$Ifִ t"& 88    44 a> ? @ A B C 8kdZ$$Ifִ t"& 88    44 a du$G$IfC  du$If :$G$If C9090 du$If :$G$Ifkdl$$Ifִ t"& 88    44 a du$If :$G$If     C9090 du$If :$G$Ifkd~$$Ifִ t"& 88    44 a     ! " # $ % & du$If :$G$If & ' 8 9 C90 du$If :$G$Ifkd$$Ifִ t"& 88    44 a9 = > A B E F I J M N Q R U ;:$G$If :$G$If /:$G$If du$If  :$G$If U V c d C90 du$If s$G$Ifkd $$Ifִ t"& 88    44 ad i j n o s t x y } ~ ;s$G$If s$G$If /s$G$If du$If  s$G$If C>>9>gd~gd~kd $$Ifִ t"& 88    44 a  GHs{|?Skgd~gd~`gd~6 00PBP/ =!"#$% $$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  /  / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ /  / / / / 4 a$$If!vh5 558555558#v #v#v8#v#v8:V 5 558558/ / / / /  / 4 aL@L Normal1$CJOJQJ_HhmH sH tH D@D Heading 1$@&5CJOJQJDA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List <&< Footnote Reference6U@6 Hyperlink >**z-.$12;<=>?@ABC !"#$%&'89=>ABEFIJMNQRUVcdijnostxy}~  GHs{|?Sk$x$hG$hG$hG$hG$tA$X$$$$hG$\M$XhGhG+hGhGhGhGhG+hGhGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGhGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGhGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGhGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGhGHY+HYHYHYHYHY+HYehGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGehGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGehGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGehGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hG/hGHYhG+HY+hGHYhGHYhGHYhGHYhG+HY+hGp$X$hG$tA$hG$hG$hG$tA$hG$hG$hG$hG$hG$hGXXXXXXX-.Im$12^_`abcdefghijklm;<=>?@ABC !"#$%&'89=>ABEFIJMNQRUVcdijnostxy}~  GHs{|?Sk000000000000000 0 0 0 0 0 0 0 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 0 0 0 0 0 0 0 0 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 0 00 00 00 00 00 00 00 0 00000000 0 0 0 0 I0I0@0I0I0I0I0I0I0@00 -.Im$12^_`abcdefghijklm;<=>?@ABC !"#$%&'89=>ABEFIJMNQRUVcdijnostxy}~  GHs{|K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@ K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 p@K0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 pK0 p@K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0 K0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0pK0p@K0K0K0K0K0K0K0K0K0K0K0K0K01 a l > C  & 9 U d   8@z(  B    B S  ? %t8M#$#9M#D^j› ^k›D ^l› ^m› ^n› ^o›D ^'$22??+#.>>RR?*urn:schemas-microsoft-com:office:smarttags stockticker=*urn:schemas-microsoft-com:office:smarttags PlaceName=*urn:schemas-microsoft-com:office:smarttags PlaceType9*urn:schemas-microsoft-com:office:smarttagsState9*urn:schemas-microsoft-com:office:smarttagsplace;*urn:schemas-microsoft-com:office:smarttagsaddress:*urn:schemas-microsoft-com:office:smarttagsStreet $ km:3\N\0^`0o(.^`. L ^ `L.  ^ `.xx^x`.HLH^H`L.^`.^`.L^`L.\±        yzg.w~$12^`bdfhjlm;<=>?@ABC "$&'8=AEIMQUVcinsx}@HP LaserJet 4 PlusLPT1:winspoolHP LaserJet 4 PlusHP LaserJet 4 Plus4C odXXLetterDINU"4e HP LaserJet 4 Plus4C odXXLetterDINU"4e 0H@@UnknownGz Times New Roman5Symbol3& z Arial?5 z Courier New"A hrfrf,b&  ! 2d3Q HX(?~2 Jean Seriojserio onI.Professional Performancea.Did the co- op student attend regularly?Yes No_____ b.Did the co-op s&lt;/p&gt;T&lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUATION FORM ___________________________________Name of StudentDates at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regularly?Yes No_____ b.Did the co-op s&lt;/p&gt;EktTaxCategoryRoot Entry Fp8SiData !1Table)WWordDocument8@  "#$%&'(*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTVa\[]j^_`UbZRoot Entry F:iData !1Table)WWordDocument8@ d4P@@z@pX@pXCo-op Evaluation FormDr. Lon H. Ferguson fergusonDr. Lon H. Ferguson fergusonT&lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUA՜.+,D՜.+,x4     Title Html Content       $4,     EkSummaryInformation(DocumentSummaryInformation8 CompObjqBagaaqy23kudbhchAaq5u2chNd8(oZ(oZtContentIDEktContentLanguage EktFolderId EktQuickLinkEktContentTypeEktFolderName EktCmsPath EktExpiryType EktDateCreated EktDateModified EktTaxCategory EktCmsSizeEktSearchableEktEDescriptionEktShowEvents EktInPermEktContentID64EktFolderId64ekttaxonomyenabled A+ ye@7LZ@Z$$$$$$\$ \$ \$ \$ \$ \$ \Summary &lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUATION FORM ___________________________________Name of StudentDates at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regularly?Yes No_____ b.Did the co-op s&lt;/p&gt;T&lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUATION FORM TION FORM ___________________________________Name of StudentDates at SiteName of Organizatipen('/WorkArea/s ___________________________________Name of StudentDates at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regularly?Yes No_____ b.Did the co-op s&lt;/p&gt;A+yyDownloadAsset.aspx?id=11073 No_____ b.Did the co-op s&lt;/p&gt;y at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regula  "#$%&'(*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTVm\jefgkdlUn d4P@@z@pX@pXCo-op Evaluation FormDr. Lon H. Ferguson fergusonDr. Lon H. Ferguson fergusonT&lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUA՜.+,D՜.+,x4     Title Html Content       $4,     EktContentIDEktContentLanguage EktFolderId EktQuickLinkEktContentTypeEktFolderName EktCmsPath EktExpiryType EktDateCreated EktDateModified EktTaxCategory EktCmsSizeEktSearchableEktEDescriptionEktShowEvents EktInPermEktContentID64EktFolderId64ekttaxonomyenabled A+ ye@7LZ@Z$$$$$$\$ \$ \$ \$ \$ \$  \Summary &lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUATION FORM  3 !"#$%&'()*+,-./012I456789:;<=>?@ABCDEFGHJKLMNOPQRS  FMicrosoft Office Word Document MSWordDocWord.Document.89q ]8O8m008@H DAV:getcontentlanguageen-usOh+'0\,p ,  CONTENTS ___________________________________Name of StudentDates at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regularly?Yes No_____ b.Did the co-op s&lt;/p&gt;T&lt;p&gt;IUP SAFETY SCIENCES CO-OP EVALUATION FORM TION FORM ___________________________________Name of StudentDates at SiteName of Organizatipen('/WorkArea/s ___________________________________Name of StudentDates at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regularly?Yes No_____ b.Did the co-op s&lt;/p&gt;A+yyDownloadAsset.aspx?id=11073 No_____ b.Did the co-op s&lt;/p&gt;y at SiteName of OrganizationI.Professional Performancea.Did the co- op student attend regula