BHWD (MIP) Intern Pre/Post Evaluation Survey

Questions marked with a * are required
Directions: There are no right or wrong answers on this survey. This survey will be used to help assess and understand how this mentored internship contributed to the development of your knowledge and skills. Information from this survey will only be reported in aggregate. Your individual responses will be kept confidential.   
Date of survey completion
Intern Contact Information
Internship Start Date
Internship End Date
(If you do not know your exact internship end date yet, please give your best estimate of when you will complete your internship.)
Education Institution
Intern Education Level
Grantee Agency Name
Organization Unique ID
(Please ask the MIP Coordinator for this information. It should be formatted as MIPXXXX.)
What stage of the internship are you in?
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