Applied Project – AEP 593 INTERNSHIP APPROVAL FORM applied ethics & the professions Biomedical & Health Ethics Submit completed form to the SFIS Graduate Program Advisor in Interdisciplinary B, Room 366. STUDENT INFORMATION Last Name First Name M.I. Date ASU Affiliate ID (10-Digit) ASU Email Address Phone Number Local Address City State Zip Code Graduate Coursework GPA Plan of Study GPA Course Credit Hours Completed PROPOSED INTERNSHIP Planned Internship Session (Select One) Fall Spring Summer Year Possible Internship Site Name Site Address City State Zip Internship Site Supervisor Phone Number Email Address Are you currently employed at this site? Yes No If yes, please provide the following information: Name of Current Supervisor Phone Number Email Address Current Work Schedule Current Number of Hours per Week Student Signature _____________________________________________________ Date _____________________ Internship Site Supervisor Signature_______________________________________ Date _____________________
INTERNSHIP MIDTERM EVALUATION applied ethics & the professions Biomedical & Health Ethics Submit completed form to the SFIS Graduate Program Advisor in Interdisciplinary B, Room 366. Date: Student Name (Last, First, MI): Internship Site: Supervisor: Evaluation Rating Scale 5 Outstanding: This is the highest rating. The intern’s performance consistently excels beyond expectations in all aspects of the internship. 4 Strongly meets expectations: Performance is above what is expected. The intern is proficient in all aspects of the internship and excels beyond expectations in some aspects of the internship. 3 Meets Expectations: Intern is proficient in all aspects of this component/position. 2 Partially meets expectations: The intern’s performance is proficient in most aspects of the internship, but he or she has immediate development needs in at least one area. 1 Does not meet expectations: The intern’s performance does not meet the minimal expectations of performance for the internship. Immediate improvement is needed. Please use the evaluation rating scale above and mark the number that best corresponds to how you rate the performance of the intern in each of the categories listed below. Share this with the student to help them identify their areas of strengths and opportunities for growth. Is punctual 5 4 3 2 1 N/A Is willing to assume all tasks 5 4 3 2 1 N/A Completes tasks with little supervision 5 4 3 2 1 N/A Completes tasks with few or no mistakes 5 4 3 2 1 N/A Assumes responsibility once a routine task has been done 5 4 3 2 1 N/A Shows outstanding preparation 5 4 3 2 1 N/A Applies academic knowledge to real work situations 5 4 3 2 1 N/A Displays initiative and good judgment 5 4 3 2 1 N/A Overall performance 5 4 3 2 1 N/A
GRADUATION PLANS applied ethics & the professions Biomedical & Health Ethics Submit completed form to the SFIS Graduate Program Advisor in Interdisciplinary B, Room 366. STUDENT INFORMATION LAST NAME FIRST NAME m.i. DATE (00/00/0000) asu AFFILIATE id (10-DIGIT) ASU EMAIL ADDRESS ALTERNATE EMAIL ADDRESS LOCAL ADDRESS CITY STATE ZIP Date Plan of study was approved (Approved Plan of Study must be on file with the Graduate College before the student begins AEP 593) graduate coursework gpa plan of study gpa course credit hours completed towards degree FACULTY MENTOR INFORMATION LAST NAME FIRST NAME EMAIL ADDRESS APPLIED PROJECT ACTIVITIES Registered for AEP 593 Term(s): Completed Date: In progress Anticipated completion date: INTERNSHIP (if applicable) Completed Date: In progress Anticipated completion date: All internship forms submitted Date: INTENDED GRADUATION Year: Spring Summer Fall SIGNATURES Student Signature ______________________________________________________ Date ____________________ Faculty Mentor Signature __________________________________________________ Date ____________________
Report of Final Master’s Culminating Experience Applied Project – AEP 593 Applied Ethics & the Professions Biomedical & Health Ethics NAME OF STUDENT (Last name, first name, middle initial) 10 DIGIT ASU AFFILIATE ID# MASTER OF Master of Arts MAJOR Applied Ethics and the Professions – Biomedical and Health Ethics APPLIED PROJECT TITLE COMPLETION DATE – MM/DD/YYYY APPLIED PROJECT EVALUATION CHART AREAS OF PERFORMANCE 5 4 3 2 1 Excellent Very Good Satisfactory Poor Unsatisfactory 1. Identification and framing of applied ethics problem 2. Research of the applied ethics problem 3. Analysis of the applied ethics problem 4. Written Communication of Project Results 5. Oral Communication of Project Results NAMES OF COMMITTEE as they appear on approved POS SIGNATURES PASSED FAILED DATE CHAIR (Faculty Mentor) □ □ MEMBER (Reader) □ □ NAME OF HEAD OF ACADEMIC UNIT SIGNATURE PASSED FAILED DATE □ □ SFIS Internal Evaluation Form – Report of Final Master’s Culminating Experience – APPLIED PROJECT July 2015