J-1 Intern/Trainee Final Evaluation Form

* All fields are mandatory. Please make sure you fill out all fields before submitting the form, thanks!

Participant Name

Participant AAG ID Number

Participant DS-2019 Number

Name of Host Company

Name of Supervisor

Q1: Level of Satisfaction with the Program
Could not be more satisfied
Very satisfied
Satisfied
Dissatisfied
Very dissatisfied

Q2: Training Plan Completion
Completed additional training
Completed all phases ahead of schedule
Completed all phases on time
Struggled to complete all phases
Failed to complete all phases

Q3: Level of Satisfaction with your Placement
Could not be more satisfied
Very satisfied
Satisfied
Dissatisfied
Very dissatisfied

Q4: What do you consider to be the best aspect of the J-1 Internship Program?

Q5: What are the top strengths you think that you have gained while on the program?

Q6: How will you apply what you have learned in the future, professionally and personally?

Q7: What cultural activity(s)/opportunity(s) have you experienced during the last months of your program?

Q8: Will you be willing to refer the program to some other international participants? Yes No

The electronic signatures below indicate that the Intern/Trainee and Host Company representative have completed this evaluation together and agree to all points.

Participant's Name

Signature

Supervisor's Name

Signature

Date