Forms Manager

Site Visit/Conference Call

Please complete the following form during your site visit/conference call (or shortly thereafter). If you have any questions about the form, more in-depth success stories you'd like to share, or concerns about your internship, please contact the XPD - Experience and Professional Development Office at 320-363-5707 or email program administrator, Laura Hammond at [email protected].

Date:

Insert the meeting date.

Site Visit Location

Please indicate whether the site was completed virtually (using phone or Zoom) or on-site (in-person).

	Virtual
	In-Person

Intern's Name:

Please include your first and last name.

Major:

Faculty Moderator's Name:

Please include their first and last name.

Faculty Moderator's Email:

Enter this accurately! This field is used to send a copy of this report to your moderator. If this is inaccurate, reports aren't sent!

Site Supervisor's Name:

Please include their first and last name.

Please describe some of the highlights of the visit/call:

What is one success story you shared?

What is one area of opportunity for improvement you discussed?

Were any concerns discussed?

	Yes
	No