J-1 Intern/Trainee Midterm 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: What skills/knowledge do you think you have gained since the beginning of your program?
Q2: What skills/knowledge would you like to gain for the rest of your program?
Q3: What do you consider to be the most beneficial aspects of your experience in the United States, so far?
Q4: What do you consider to be the most challenging aspects of your experience in the United States, so far?
Q5: Are you on track with the Training plan phases?
Yes
No
Q6: If not, which phase(s) was not completed yet?
Q7: What cultural activity(s)/opportunity(s) have you experienced during the first semester?
Q8: Have you recently changed of home address? If so, please write your new address information below:
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
Send Midterm Evaluation