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United States
Environmental Protection
Agency
Region V
230 South Dearborn Street
Chicago, Illinois 60604
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U.S Environ
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Faction Agency
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REGION V
COOPERATIVE EDUCATION PROGRAM
TABLE OF CONTENTS
Paragraph
Cooperative Education Program for Baccalaureate Students
A. Introduction Page 1
B. Responsibilities Page 1
C. Program Implementation Page 2
D. Conditions of Student Employment Page 3
Appendix "A" Checklist for CO-OP Appointment
Appendix "B" Checklist for Promotion of CO-OP Student
Appendix "C" Checklist for Return to Duty of CO-OP Student
Appendix "D" Checklist for Conversion to CO-OP Student to
Competitive Appointment at GS-5
Appendix "E" Checklist for Conversion of CO-OP Student to
Competitive Appointment at GS-7
Appendix "F" Evaluation of Cooperative Education Students
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REGION V
Cooperative Education Program for Baccalaureate Students
A. INTRODUCTION
The U.S. EPA has recognized cooperative education as a method for
strengthening the career service in professional, administrative and
technical occupations. The benefits to the employer are many. Co-
operative education permits selection for career jobs on the basis of
proven performance and reduces the costs of high turnover that is
characteristic of the first three years on a job. It can also foster
greater understanding among students and college faculties of Federal
job opportunities. It provides an excellent recruitment vehicle for
minority candidates and women, in addition to providing early exposure
to the work environment for the physically handicapped college students.
Region V's Cooperative Education Program for Baccalaureate Students is
a staffing program which provides periods of study-related, paid employ-
ment to students in 4-year colleges who are pursuing a baccalaureate
curriculum in a qualifying educational institution.
8. RESPONSIBILITIES
Agency Managers/Supervisors
- Committing a realistic number of temporary slots to be allocated
to the cooperative education program annually.
- Assuring the cooperative education student's work assignments are
meaningful and developmental in nature.
- Making a commitment to absorb successful cooperative education
graduates into the permanent workforce within the region.
Insuring placement of students in previously-identified target
occupations or occupations related to their field of education
and cooperative education experience when a vacancy will permit
the graduating student to be converted to a career or career-
conditional appointment.
- Assuring that the work experience of student(s) working under
their supervision is a meaningful supplement of his/her field of
study and will adequately prepare him/her for a related career
f i el d.
- Responsible for insuring that a training plan is developed for
each student.
- Assuring that all appropriate cooperative education document re-
garding the student's appointment are processed accurately and
timely e.g., SF 52, checklists, evaluations, etc.
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REGION V
- Evaluate student in writing at end of a trial period.
Regional Personnel Officer
- Conducting recruitment drives with various educational institu-
tions to develop positive awareness of the program among educa-
tional institutions and prospective cooperative education students.
- Training personnel specialists and managers concerning cooperative
education appointments and program advantages.
- Establishing and operating a viable cooperative education program
within the region.
- Establish an annual participation goal which best meets the future
recruitment needs of the Region and incorporates affirmative
action goals and objectives.
- Designating a Regional Cooperative Education Coordinator who has
overall responsibility within the region and who is allocated
sufficient time and resources to effectively carry out program
responsibilities.
- Performing analyses of office responsibilities and objectives to
determine where and if cooperative education students can effec-
tively meet an office's staffing needs and objectives.
- Insuring that personnel actions involving cooperative education
students are accurate and comply with FPM regulations as well as
all other applicable directives.
Regional Cooperative Education Coordinator
- Has overall program responsibility including the design and
management of the program.
- Insuring that the agreements between the U.S. EPA and participa-
ting educational institutions are executed in accordance with FPM
Chapter 308.
Insuring that participating institutions are composed of a repre-
sentative number of minority and female students
College and University
- Designating a representative to work with the region's co-op
coordinator.
- Publicizing EPA's program to their students.
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REGION V
- Referring all interested and qualified candidates to the agency
without descrimination, including veterans discharged under honor-
able conditions.
- Furnishing the agency with requested information about the student's
field of study and academic standing.
- Informing the agency of the change in student's status, including
termination of study, change from full-time enrollment, shifts to
other major areas of study, and failure to maintain required stand-
ards of the institutions or agency.
C. PROGRAM IMPLEMENTATION
Cooperative Education Agreement
When recruiting students, contacts should be made with local universities.
If a school is interested in placing students in positions with EPA,
contact your servicing staffing specialist who will arrange to have the
school enter into a cooperative education agreement, if necessary. An
agreement must be signed before a student can be placed in a position.
The agreement becomes void if no students from the college were employed
in the previous 12-month period.
D. CONDITIONS OF STUDENT EMPLOYMENT
1. Student Eligibility - In addition to meeting eligibility standards
imposed by FPM Chapter 302, the student must:
a. Be a full-time student enrolled in a curriculum leading
to a Bachelor's Degree.
b. Have completed his/her freshman year.
c. Be enrolled in the school's cooperative education program.
d. Be recommended for assignment in the agency by the appropriate
staff of the educational institution.
e. Be a Citizen of the United States of America or a native of a
country which owe's permanent allegiance to the United States
(e.g. American Samoa).
f. Not be the son or daughter of an employee of the employing
agency (except under the unusual circumstances set forth in
Appendix C of Chapter 213 of the Federal Personnel Manual),
and not be a member of a household in which two other family
members (including immediate relations other than parents) are
employees of the Federal Government on competitive appointments.
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REGION V
g. Be 16 years of age or over.
h. Be maintaining at least a 2.0 overall average on a 4.0 scale
or the equivalent, a grade C or above in all major fields of
study at all times, and a record that is in all aspects pre-
dictive of graduation.
i. Meet medical requirements, as appropriate.
j. Meet security requirements, as appropriate.
2* Selection - Selection of cooperative education students is subject
to applicable provisions of the FPM Chapter 3U2,
Employment in the Excepted Service. In addition, the
following provisions also apply:
a. Agencies have final responsiblity for selection of students
recommended by colleges.
b. Selections are subject to all laws and policies governing equal
opportunity in the Federal Service.
3. Appointment
a. Students are given appointments in the excepted service under
Schedule B, Section 213.3202(a) of the code of Federal regulations.
b. All appointments are for the full period extending from the
initial appointment to a date not to exceed 12U days after
graduation. Extension beyond the 120 days after graduation
violates the provisions of an Executive Order of the President
of the United States. If formalities of graduation are delayed,
the 120 day period begins on the 15th day after the college
issues notice and testifies to the student's graduation.
c. A student's appointment may be terminated at any time for any
of the following reasons:
- Resignation
- Change to a curriculum which will not qualify him/her
for the position
- Suspension, expulsion or withdrawl from the
educational institution
- Unsatisfactory work performance
- Failure to maintain academic standards
- Physical unfitness for duty
Inability of the agency for administrative reasons to
retain the student in the job
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REGION V
d. Before a student is officially appointed, a "Checklist for CO-
OP Appointment" must be completed. See Appendix "A"
4. Pay and Benefits
a. Students will be paid in accordance with the regular pay
schedules established for their grades. Students may be
authorized to work overtime.
b. Students are paid for holidays which fall within their work
periods if regulations qualify them for such pay.
c. Students earn sick leave at the rate of 4 hours per pay period
and annual leave at the rate authorized for their length of
Federal Service, including military service.
d. For students holding appointments which exceed 1 year, partic-
ipation in the Federal Retirement System and PICA is mandatory.
In the unforeseen situations in which the appointment is less
than 1 year, the student will be covered under FICA only.
e. The student who is expected to be in pay status for at least
one third of the time of the appointment will receive life
insurance unless waived and may also elect optional life insurance
and health benefits.
f. When not in pay status, students will be placed on leave-without-
pay.
g. Tuition assistance may be given subject to Federal Regulations
outlined in FPM Chapters 308 and 410.
h. Travel to the Student's first duty station may be paid upon
conversion to a career conditional appointment providing that
the first duty station appointment is to a position for which
there is a shortage of qualified candidates, in accordance with
FPM 571, Subchapter 2.
5. Classification and Promotion
a. Cooperative Education positions under this agreement are at the
GS levels 2 through 5. However, no initial appointments will be
made at GS-5.
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REGION V
b. The following qualification standard for the Student-Trainee
series, GS-099, will be used to apply education and experience
requirements regardless of the classified series of the positions.
Student Trainee - GS-2: None
Student Trainee - GS-3: One full year of academic study
(30 semester hours)
Student Trainee - GS-4: Two full years of academic study
(60 semester hours)
Student Trainee - GS-5: One of the following:
- Completion of three-fourths of the total number of periods
of study required for the bachelor's degree and one period
of employment at GS-4.
- Completion of two and one-half years of academic study plus
six months of GS-4 work experience.
c. Promotion from one grade to another is contingent upon the
student's meeting not only the above qualification standards
but also the performance requirements of the agency. Although
promotion is at the discretion of the agency, students are
usually moved through grades so that they will qualify for at
least GS-5 upon graduation.
d. Before a promotion can be processed, a "Checklist for Conversion
of CO-OP Student to Competitive Appointment at GS-5" must be
completed. See Appendix "B"
6. Student Work Schedules and Intermittent Eligibility Status
The manager and university share the responsibility of developing a
program design that offers maximum advantages to both themselves
and the student, subject to the following conditions:
a. Each Student's work experience must be carefully planned to
supplement his/her study and prepare him/her for a related
career field.
b. Schedules will involve alternating periods of full-time study
and full-time work or part-time work. Part-time work schedules
may be arranged only upon written certification from an appro-
priate school official indicating that such an assignment is
acceptable as a regular part of their academic cooperative
education curriculum. In arranging part-time work schedules,
agencies should keep in mind that these students are required
to be in attendance in school on a full-time basis.
c. Work periods may include summers but must not be confined to
summers.
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REGION V
d. Work will be scheduled so that the student, by the date of
graduation, can complete the required number of periods (2)
and hours of work (1040) required to make them eligible for
non-competitive conversion to a career or career-conditional
appointment during the 120 days after graduation. Students
may work up to 1300 hours during a 12-month service year.
e. In order to determine a CO-OP Student's eligibility status
from one work-period to the next, a "Checklist for Return to
Duty of CO-OP Student" must be completed. See Appendix "C".
7. Trial Period and Performance Appraisals
a. The student's first work period is to be considered a screen-
ing period, during which time the student's strengths and
weaknesses are carefully observed and assessed. Assistance
is to be given on a continuing basis to help the student pro-
gress and learn all aspects of the job. Every effort must be
made to screen out candidates who do not show promise for
future career service.
b. Performance Standards will be established and students will be
appraised in accordance with EPA's Performance Management System
policy for Non-SES, Non-PMRS employees. Additionally, students
are to be evaluated at the end of each work period. The form
to be used is titled "Evaluation of Cooperative Education Students."
Three copies of the form are to be completed; the original should
be sent to the regional coordinator and will be placed in the
student's Official Personnel Folder. One copy should be given to
the student; and the third copy is for the supervisor's files.
See Appendix "F".
After preparing the evaluation, the supervisor should meet with
the student to discuss his/her performance. The supervisor
should fully explain his/her performance expectations to the
student, so that there will be no misunderstanding. After the
supervisor discusses the appraisal with the student, the appraisal
form should be given to the student for completion of his/her
part of the form.
The evaluation form provides a space for the supervisor to make
recommendations of retention or termination. The determination
must be made following every work period. (On the last evalua-
tion prior to graduation, the supervisor is to recommend the
student either for conversion to career status to termination.)
Anytime termination is being considered, the regional coordinator
must be informed before any action is taken.
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REGION V
8. Personnel Ceilings and Student Status
a. Cooperative education students count against permanent employment
ceiling. Students are carried on EPA rolls for the full period of
their cooperative appointment. A student must complete one full
work period during the first year on the rolls. The Agency does
not count students against ceiling while they are in a leave-without-
pay-status in excess of 30 days.
9. Employment After Graduation
Within the 120 days after graduation, the employing agency may convert
noncompetitively to a career or career-conditional appointment any
cooperative education student who receives a bachelor's degree and who
satisfies the eligibility requirements cited below:
a. A student is eligible for noncompetitive conversion at the GS-5
level if he or she:
- Meets the qualification standards for the position at the
GS-5 level, except for any written test.
- Still meets the citizenship and members-of-family requirements
cited earlier.
- Has completed, prior to graduation, at least two full -time periods
of work, separated by a period of study, which together totals
26 weeks or 1040 hours of work. One of the work periods must have
been scheduled other than during a summer month and one must have
been completed within 18 months of graduation.
- All work counted must be in the same field of work as the appoint-
ment and in the agency making the conversion.
NOTE: Before conversion to the GS-5 level a "Checklist for
Conversion of CO-OP Student to Competitive Appointment
as GS-5" must be completed. See Appendix "D".
A Student is eligible for noncompetitive conversion at the GS-7
level if he or she:
- Meets the qualification standards for the GS-7 position.
- Still meets the citizenship and member-of-family requirement.
- Has served at the GS-5 level as a cooperative education student
for 12 calendar months, of which 60-days have been in work
status.
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REGION V
- Meets one or the other of the following two requirements:
(1) Has served in work status (i.e., excluding LWOP time)
for a total of at least 52 weeks, (2080 hours) between
appointment and graduation; the work has included at_
least 2 separate periods prior to graduation with an
intervening period of study; both periods were at least
immediately prior to graduation; at least 1 of the 2
periods counted for the purpose of conversion did not
fall wholly within the established summer employment
period; and both periods were in the same agency and
the same field of work in which the student is seeking
conversion, or_
(2) Has completed 26 weeks in work status as required for
non-competitive conversions at the GS-5 level and has
also met the conditions of the Office of Personnel
Management's Superior Academic Achievement Provision.
NOTE: Before conversion to the GS-7 level a "Checklist for
Conversion of CO-OP Student to Competitive Appointment
at GS-7 must be completed. See Appendix "E".
c. Specific requirements for noncompetitive conversion should be given
to the student in writing. This can be done by providing them with a
copy of the agreement or other written guidance outlining program
requirements. Each Servicing Personnel Officer is responsible for
assuring that agreements are in line with EPA and Federal policies.
d. Although the prime purpose of Federal employment of cooperative educa-
tion students is to prepare students for the agency's permanent work
force, an agency sometimes cannot, for administrative reasons, convert
non-competitively all the graduates which it has trained as students or
cannot convert at the grade for which a person is eligible. Students
who are not converted may seek eligibility through the competitive
process in the same or another area of work. Those who do not meet the
work requirements for noncompetitive conversion at the GS-7 level may
also seek eligibility at that level through the competitive system.
Students disqualified from continuing in the Cooperative Education
Program or are not appointed within the 120 days after graduation will
be terminated.
Separation from these causes will provide no right of appeal to 0PM and
they do not require agencies to follow the procedures of Part 752 of ,
0PM regulations except in the rare case of a veteran who completes 1
year of current continuous employment.
e. A student who has participated in a cooperative education program and
received his/her bachelor's degree cannot be appointed again under
schedule B, section 213.3202(a) if he/she returns to college to complete
a second bachelor's degree.
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REGION V
f. Students may be given only one Schedule B Cooperative Education appoint-
ment in the same agency. This appointment is continued for the full
length of participation in the work-study program until such time as
the student is either converted or terminated. Reappointments to the
program may be made only in cases where the student has withdrawn for
hardship reasons (e.g., illness, financial, etc.)- Students whose
appointments are terminated for failing to meet either school or agency
academic standards may not be reappointed.
10. Crediting Experience - Tenure
a. Schedule B cooperative education experience is creditable toward the
one-year probationary period required of persons converted under
Executive Order 12015 if they meet the conditions stated in FPM chapter
315, appendix A. One of these conditions is that prior service was in
the same line of work and the same agency to which the person is
converted. Same line of work means that the two positions are so
similar that they require the same qualifications and, insofar as the
nature of the work is concerned, would be in the same competitive
level for reduction in force purposes. LWOP in excess of 22 workdays
is not creditable.
b. Cooperative education work experience under Schedule B may be counted
toward career tenure as provided for in FPM chapter 315, subchapter 2.
The basic rule is that students converted to career or career-conditional
appointments under Executive Order 12015 receive credit towards career
tenure for work periods performed under a Schedule B appointment.
Students also receive credit for the first 30 calendar days of each
LWOP period.
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REGION V
APPENDIX "A"
CHECKLIST FOR CO-OP APPOINTMENT NAME:
1. SF-52 approved by Division and Budget Office
2. Qualifications/Eligibility
a. SF-171 (original, signed) received.
b. U.S. Citizen.
c. Member of family requirements.
d. Nepotism
e. (1) For GS-3: 1 year college completed.
(2) For GS-4: 2 years college completed.
f. Academic standing requirement: (Both 1 and 2)
(1) 2.0 grade point average on a 4.0 scale.
(2) "C" average in all major fields of study.
Academic eligibility must be supported by either
complete transcript or letter from appropriate
school official.
3. Letter from appropriate school official.
a. Recommending the student.
b. Certifies that student is currently in attendance
(rather than merely accepted or registered) in a
bachelor's degree program.
c. Certifies that student does not hold a bachelor's
degree.
d. Certifies that student is enrolled in the school's
CO-OP program.
e. States the anticipated graduation date (Bachelor's
Degree).
f. Meet academic requirements (See 2f above).
L Official position description signed by the immediate super-
visor and established by the Personnel Branch.
j. Signed copy of agreement with school (A new agreement is
required if there have been no students from the school
employeed in the program in the last 12 months).
5. Work schedule received (periods of employment up to time
of graduation). Part-tine work schedule documentation
attached.
APPROVED: ___^ DATE:
PERSONNEL STAFFING SPECIALIST
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APPROVED: _____ DATE:
PERSONNEL STAFFING SPECIALIST
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REGION V APPENDIX "B"
CHECKLIST FOR PROMOTION OF CO-OP STUDENT NAME:
1. SF-52 (Promotion/CO-OP Student)
2. Student is currently in a work status. (This action may be
combined with a RETURN TO DUTY provided all requirements of
both actions are met.)
3. Official position description signed by immediate super-
visor and established by Personnel Branch.
4. Experience Requirements:
a. For GS-4: Satisfactory completion of 2 full academic
years of study.
b. For GS-5: (1 or 2)
(1) Completion of 3/4 of the total number of periods of
study in college required for the bachelor's degree,
and
1 work period as a GS-4 CO-OP student in the program.
(2) Completion of 2 1/2 years of academic study in
college required for the bachelor's degree, and
6 months of work as a GS-4 CO-OP student in the
program.
NOTE: A full academic year of study is a period of combination
of periods of study at the college level equal in length
to 2 semsters or 3 quarters.
5. Signed copy of performance review completed by immediate
supervisor at the end of last work period indicating:
a. Retention in the program was recommended.
b. Date performance review was discussed with student.
6. Academic requirements (Both 1 and 2).
(1) 2.0 grade point average on a scale of 4.0.
(2) "C" average in all major fields of study.
NOTE: Academic eligibility (Paragraph 4 & 6 above) must be
supported by either:
(1) Complete, current transcript, or
(2) Letter from appropriate school official.
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REGION V
APPENDIX "C1
CHECKLIST FOR RETURN TO DUTY OF CO-OP STUDENT*
NAME:
1. SF-52 (RTD FROM LWOP/CO-OP STUDENT)*
2. Signed copy of performance review completed by immediate
supervisor at the end of the last work period indicating:
a. Retention in the program was recommended.
b. Date performance review was discussed with student.
3. Academic requirements: (Both 1X2).
(1) 2.0 grade point average on a scale of 4.0.
(2) "C" average in all major fields of study.
Academic eligibility must be supported by either
(1) Complete, current transcript, or
(2) Letter from appropriate school official.
* This action may be combined with promotion provided all require-
ments of both actions are met. Submit SF-52 for RTD & Promotion/
CO-OP Student.
APPROVED: DATE:
PERSONNEL STAFFING SPECIALIST
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REGION V APPENDIX "D1
CHECKLIST FOR CONVERSION OF CO-OP STUDENT TO COMPETITIVE APPOINTMENT AT GS-5
NAME:
1. Effective date not later than 120 days after
graduation (award of bachelor's degree).
NOTE: The 120 day limit cannot be extended.
2. Evidence of completion of bachelor's degree require-
ments (i.e., diploma, transcript, or letter from
appropriate school official) including any required
courses.
3. Completed 26 weeks (1040 hours) of full-time coopera-
tive education work experience in the EPA prior to
graduation.
4. Completed 2 separate work periods with an interven-
ing period of study prior to graduation.
a. The last work period was within 18 months of
the expected graduation date.
b. The required hours (1040 hours) were in the same
occupational series as the position to which the
students is to be appointed, and was related to
the student's major field of study.
5. U.S. Citizen
6. Meets member of family restriction
7. Is recommended for conversion to competitive appoint-
ment not later than 120 calendar days after completion
of CO-OP program.
8. SF-52 CONVERSION TO COMPETITIVE APPOINTMENT
NOTE: CO-OP students who do not meet the above requirements
may seek entry level career-conditional appointments
at GS-5 or GS-7 through the competitive process.
APPROVED: DATE:
PERSONNEL STAFFING SPECIALIST
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REGION V
APPENDIX "E"
CHECKLIST FOR CONVERSION OF CO-OP STUDENT TO COMPETITIVE APPOINTMENT AT GS-7
NAME:
1. Effective date not later than 120 days after gradua-
tion (award of bachelor's degree).
NOTE: The 120 day limit can not be extended.
2. U.S. Citizenship.
3. Meets members of family requirement.
4. Is recommended for conversion to competitive appointment no
later than 120 days after completion of the CO-OP program.
5. Meets the competitive qualification requirements in the
field of work for which he/she received his/her training,
including completion of any specialized courses required
for the position for which he/she has been in training.
6. Completed all the requirements for a bachelor's degree not
more than 120 days before the date of conversion.
7. Has served at the GS-5 level as a cooperative education
student for 12 calendar months, of which 60-days have been in
work status.
8. Meets either of the following two requirements:
a. Has served in work status (i.e., excluding LWOP time) for a
total of at least 52 weeks (2080 hours) between appointment
and graduation;
(1) the work has included at least 2 separate periods
prior to graduation with an intervening period of
study;
(2) both periods were at least 60-days in length
(3) 1 period fell within the 18-months immediately
prior to graduation;
(4) at least 1 of the 2 periods counted for the purpose
of conversion did not fall wholly within the esta-
blished summer employment period (May - Sep);
(5) both periods were in the same agency and the same
field of work in which the student is seeking
conversi on.
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REGION V
APPENDIX "E" CONTINUED
CHECKLIST FOR CONVERSION OF CO-OP STUDENT TO COMPETITIVE APPOINTMENT AT GS-7
b. (1) Has completed 26 weeks in work status as required
for noncompetitive conversion at the GS-5 level and
(2) Has also met the conditions of the Superior Aca-
demic Achievement provision (a, b, c, or d).
a. Standing in the upper third of their class based
on completed college work;
b. College grade average of "B" (2.90) of a possible
4.0) or better or equivalent. This is either:
(i) the average of all completed college courses,
or
(ii) the average of all college course completed
during the last 2 years of the undergraduate
curriculum.
c. College grade average of B+ (3.5) or better (or
equivalent) in the major field, where such field
is fully qualifying and directly applicable to the
specialty field of the position to be filled. This
is either:
(i) the average of completed courses in the major
field, or
(ii) the average of college courses completed in
the major field during the last 2 years of the
undergraduate curriculum.
d. Election to membership in Phi Beta Kappa, Sigma xi,
or one of the national honorary scholastic societies
meeting the minimum requirements of the Association of
College Honor Societies, other than freshman honor
societies.
NOTE: Fulfillment of the requirements for conversion at the GS-7, permits
but does not obligate the agency to convert at the GS-7 level.
CO-OP students who do not meet the above requirements may seek entry level career-
conditional appointments at GS-5 or GS-7 through the competitive process.
AP°ROVED: DATE:
PERSONNEL STAFFING SPECIALIST
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REGION V
EVALUATION OF COOPERATIVE EDUCATION STUDENTS
APPENDIX "F1
Student's Name:
Grade:
Office to Which Assigned:
Position Title:
Training Period:
Immediate Supervisor:
PART I - TO BE COMPLETED BY SUPERVISOR
FPM Chapter 308 requires that students must be evaluated toward the end of each
work period. All appraisal information should be shared with college coordinators
and made a part of the student's personnel folder. The final appraisal should
include a recommendation regarding conversion.
SECTION A - Performance Assessment.Assess the student's performance in each of the
following categories. If you feel that improvement is necessary in any area, you must
explain the reason for your rating in the Remarks section.
CATEGORY
1.
I.
3.
4.
b.
6.
/.
8.
9.
10.
Volume of work produced
Quality of work produced
Accuracy and thoroughness
Ability to learn
Analytical ability
Sensitivity to problems and
ability to resolve them
Original and creative thinking
Ability to work under pressure
Effectiveness in oral
communications
Effectiveness in written
communications.
ABOVE
AVER.
AVER.
BELOW
AVER.
REMARKS
SECTION B - Work Habits. Evaluate each characteristic individually. If you feel that
improvement is necessary in any area, you must explain the reason in the Remarks section.
CATEGORY
1.
2.
Effective in preparing and
organizing his or her work
Takes the initiative, is a self-
starter
3. Has ability to adjust to non-
routine assignments
4.
b.
b.
Keeps constructively busy and
mentally alert
Has positive attitude towards
organization, its objectives and
policies
Is cooperative in working rela-
tionships with others
7. Exhibits diligence and perser-
verance.
8.
Demonstrates a willingness to
accept responsibility
ABOVE
AVER.
AVER.
BELOW
AVER.
REMARKS
ATTENDANCE:
PUNCTUALITY:
/ Regular
Regular
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REGION V
APPENDIX "F"
SECTION C - Problem Check List. In consideration of the student's total performance,
indicate those characteristics that may have had a negative effect on his or her
overall effort. Check only those categories that are applicable.
CATEGORY
Limited technical
ability
Poor attitude
Lack of experience
Personality conflicts
Personal problems
Negative reaction to
criticism
Negative reaction
to supervison
OCCASIONAL
PROBLEM
SERIOUS
PROBLEM
CATEGORY
Lack of initiative
Poor Health
Immature
Lack of interest in
organization
Lack of interest
in the job
Inappropriate dress
OCCASIONAL
PROBLEM
SERIOUS
PROBLEM
Comments (Explanations or Examples)
SECTION D - Professional Development.What suggestions do you have for the student
in order to increase his or her value to the organization and to further his or her
professional development?
SECTION E - Certification and Recommendation.This section will serve as the
supervisory certification regarding the retention of the student in the Federal
Service. A recommendation for separation should be based on your overall evaluation
of the student's performance taking into consideration all assigned ratings. Consult
with your personnel office prior to discussing such a recommendation with the student.
I certify that the above-named student's performance, conduct, and general character
traits have been found:
/ / Outstanding
/ / Very Satisfactory
/ / Satisfactory
// Barely Satisfactory
/ / Unsatisfactory
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REGION V APPENDIX "F"
Check one of the boxes under A. if the work period the student has completed is not
his/her last one prior to graduation. Check one of the boxes under B. If it is.
A. / / I recommend that the / / I cannot recommend student's
student be retained retention in the Federal
in the Federal Service. Service
B. / / I recommend that the / / I cannot recommend the
student be converted to student's conversion to
a career/career conditional the competitive service.
appointment.
PART II - TO BE COMPLETED BY STUDENT
Pri:or to discussion of your evaluation with your supervisor, answer the following
questions.
1. Do you feel you have received adequate guidance relative to the work you are
expected to perform? If not, identify areas in which you believe you need more
guidance.
2. What additional training, either in the classroom or on the job, would be
helpful?
3. Ho you understand your supervisor's expectations for satisfactory performance
in your position?
4. Do you have a good working relationship with your supervisor. With fellow
employees.
5. Do you feel that you have adequate information on your rights, benefits and
obligations (e.g., hours of work, pay, leave, insurance, code of conduct,
promotions, incentive awards, employee organizations, appeal rights, train-
ing)?
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REGION V
APPENDIX "F"
6. Do you feel free to call your personnel office to obtain this information?
NOTE: Use space below for additonal comments or further response.
with your supervisor please sign this report below.
STUDENT REMARKS:
After discussion
PART III - SIGNATURES
Student
- After dis
supervise
Date
;cussion of Parts I and
>r and student sign belc
Supervisor
II,
)W.
Date
PERSONNEL OFFICE
USE ONLY
/ / No Action
Required
/ / Further Action
Required
PRIVACY ACT NOTIFICATION - Pursuant to Public Law 93-579 (Privacy Act 1974), the
authority to collect this information is Title 5 U.S.C. Section 301, 1302, 3301,
3302, E.O. 10577, and E.O. 12015. This form is used to evaluate the performance of
Region V's Co-operative Education Students and to certify whether they should be
retained in the program and upon graduation whether they should be converted to
career/career conditional status. It may be used to determine the need for
additional guidance and training. Completion of Part II is voluntary. This form
will be filed in the employee's Official Personnel Folder.
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