FORM 1–E:  STUDENT RECORD FORM

 Print Name                                                                                       Trade          ELECTRICAL

Student Signature                                                                          Month/Year ___________

NOTE – The hours listed above are merely annual guidelines and may not all be accomplished each year.  As students progress in trade knowledge and experience the type of work assigned will vary.

This form is due no later than the 10^th of the month

Apprentice’s Overall Progress:                   o Satisfactory          o Unsatisfactory

Employed by:______________________  Supervisor’s Signature:_____________________

EDUCATION DEPARTMENT FAX LINE: 702-220-3113

FORM 2-E MONTHLY APPRENTICE EVALUATION FORM

Month Reporting: _______________________Trade:__________________________                       

Apprentice’s Name:  ____________________________________________________

Company: ___________________ Supervisor’s Name: ______________________

                                                                                                                         ^{(PLEASE PRINT)}

Please evaluate the Apprentice in each of the areas listed below by checking the response that most aptly applies.  Please only check one box for each area.

Attitude/Motivation            o Excellent        o Good       o Average     o Fair      o Poor

Working with others          o Excellent        o Good       o Average     o Fair      o Poor

Dependability                    o Excellent        o Good       o Average     o Fair      o Poor

Following Instructions       o Excellent        o Good       o Average     o Fair      o Poor

Job Performance              o Excellent        o Good       o Average     o Fair      o Poor

Job Skills                           o Excellent        o Good       o Average     o Fair      o Poor

Progress in Trade            o Excellent        o Good       o Average     o Fair      o Poor

Trade Knowledge             o Excellent        o Good       o Average     o Fair      o Poor

Safety                                 o Excellent        o Good       o Average     o Fair      o Poor

Is the Apprentice progressing to your satisfaction?                                o yes             o no

Is the Apprentice increasing his/her job productivity?               o yes             o no

General Comments (optional):                                                                                                       

Hours Worked:              Supervisor’s Signature:                                                                           

                                        Student’s Signature:___________________________________

 NOTE TO SUPERVISOR:   Complete Evaluation Form 2-E