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WORK EXPERIENCE MIDPOINT SITE SURVEY SUMMER 2026
Thank you for supporting a student in a SDCCD Work Experience course! This is an exciting opportunity for our students to explore career pathways, build professional skills, and gain valuable hands-on training under your mentorship.
Please complete this brief midpoint check-in survey to share details about your student's Work Experience placement and their performance.
Thank you for your feedback! Your responses will help our SDCCD Work Experience Instructors improve the course and ensure students have the best possible learning experience.
Questions or need accommodations?
Please email the designated SDCCD campus Work Experience Coordinator for more information:
City College
- Nicole Vargas |
nvargas@sdccd.edu
Mesa College
- Shawn Fawcett |
sfawcett@sdccd.edu
Miramar College
- Kyoka Hashimoto |
khashimoto@sdccd.edu
WORK EXPERIENCE COURSE INFORMATION
NOTE:
Please contact the supervised student for assistance with completing this section.
Campus Enrolled in for Work Experience Course:
*
City College
Mesa College
Miramar College
Academic Term & Year:
*
Please select
Summer 2026
MESA COLLEGE Work Experience Course:
*
Please select the MESA COLLEGE Work Experience course you are enrolled in for this term.
***** WORK EXPERIENCE - Choose 1 Course Below*****
CACM 270 - 1 Unit - McCormack, B. - Class # 30440 - 8 WK: 6/2-7/25/26 - 54 Hours
CISC 270 - 1 Unit - Chow, A. - Class # 31467 - 10 WK: 6/2-8/8/26 - 54 Hours
EXSC 270 - 1 Unit - Hyatt, B. - Class # 30579 - 8 WK: 6/2-7/25/26 - 54 Hours
FASH 270 - 2 Units - Phillips, A. - Class # 30442 - 10 WK: 6/2-8/8/26 - 108 Hours
FASH 270 - 3 Units - Phillips, A. - Class # 31391 - 10 WK: 6/2-8/8/26 - 162 Hours
GIS 270 - 2 Units - Russell, R. - Class # 30220- 10 WK: 6/2-8/8/26 - 108 Hours
GIS 270 - 3 Units - Russell, R. - Class # 30516 - 10 WK: 6/2-8/8/26 - 162 Hours
HOSP 270 - 1 Unit - Lizano, A. - Class # 31392 - 8 WK: 6/2-7/25/26 - 54 Hours
HOSP 270 - 2 Units - Lizano, A. - Class # 30443 - 8 WK: 6/2-7/25/26 - 108 Hours
HOSP 270 - 3 Units - Lizano, A. - Class # 31393 - 8 WK: 6/2-7/25/26 - 162 Hours
INTE 270 - 3 Units - Hines, J. - Class # 30492 - 10 WK: 6/2-8/8/26 - 162 Hours
WORK 270 - 1 Unit - Rosenbloom, M. - Class # 30240 - 10 WK: 6/2-8/8/26 - 54 Hours
WORK 270 - 2 Units - Navarro, K. - Class # 30467 - 10 WK: 6/2-8/8/26 - 108 Hours
WORK 270 - 3 Units - Remmer, A. - Class # 31394 - 10 WK: 6/2-8/8/26 - 162 Hours
WORK 270 - 4 Units - Worthy, A. - Class # 30480 - 10 WK: 6/2-8/8/26 - 216 Hours
WORK 270 - 1 Unit - Meissner, C. - Class # 31395 - 8 WK: 6/2-7/25/26 - 54 Hours
WORK 270 - 2 Units - Song, S. - Class # 30571 - 8 WK: 6/2-7/25/26 - 108 Hours
WORK 270 (Mesa Impactship Program - MIP Students) - 1 Unit - Thompson, C. - Class # 30444 - 10 WK: 6/2-8/8/26 - 54 Hours
WORK 270 (Mesa Impactship Program - MIP Students) - 1 Unit - Guzman, A. - Class # 30529 - 10 WK: 6/2-8/8/26 - 54 Hours
WORK 270 (Mesa Impactship Program - MIP Students) - 1 Unit - Schaeg, C. - Class # 30570 - 10 WK: 6/2-8/8/26 - 54 Hours
TEST COURSE
MIRAMAR COLLEGE Work Experience Course:
*
Please select the MIRAMAR COLLEGE Work Experience course you are enrolled in for this term.
TEST COURSE
CITY COLLEGE Work Experience Course:
*
Please select the CITY COLLEGE Work Experience course you are enrolled in for this term.
TEST COURSE
STUDENT INFORMATION
Student Name
*
First
Last
Student CSID #:
*
Student Phone:
*
###
-
###
-
####
Student Email:
*
WORK EXPERIENCE COMPANY / ORGANIZATION INFORMATION
Please provide some details on the student's Work Experience placement.
Company Name:
*
Type of Work:
*
Paid
Unpaid
Site Supervisor Name:
*
Assigned person at company to supervise & evaluate student during Work Experience.
Site Supervisor Title:
*
Site Supervisor Phone:
*
###
-
###
-
####
Site Supervisor email:
*
WORK EXPERIENCE SUPERVISOR FEEDBACK
Share your perspective on each of the following questions regarding your student's Work Experience placement.
What strengths has the student demonstrated so far in their role?
*
What professional skills (e.g., communication, teamwork, technical) has the student demonstrated or improved?
*
Are there any concerns about the student completing their Work Experience?
*
Are there additional supports that would help the student succeed or make this Work Experience more valuable for the remainder of the semester?
*
Please read each statement and choose the option that most closely reflects your opinion.
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The student is applying classroom learning and technical skills effectively in the workplace.
The student is exploring and gaining awareness of career pathways in the field.
The student consistently arrives on time and maintains reliable attendance.
The student communicates effectively with supervisors and colleagues.
The student demonstrates professionalism in behavior, attitude, and interactions.
The student demonstrates initiative and accountability in completing assigned tasks.
The student manages their time effectively and stays organized.
The student adapts well to new tasks, challenges, feedback, or changes in workflow.
The student is receiving appropriate training/mentorship at our site.
Additional Comments & Feedback of Work Experience:
SITE SUPERVISOR AUTHORIZATION
Site Supervisor Signature:
*
Clear
Please use your computer mouse cursor or finger on a tablet to physically sign your name as you would for a wet signature.
UNABLE TO SIGN THE FORM?
If you have previously started the form and selected "Save & Resume Later," click on the "Clear/Delete" link in the bottom right corner of the signature field. This will clear the field and allow you to sign and submit the form.
Date Time
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MM
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YYYY
Need to finish this form later? Click “Save & Resume Later” at the bottom of this form to generate a unique URL with the information you've entered. Copy/paste the URL link to email yourself. Later or at a site visit, click on the link in your email to open the form and enter any remaining information or add a signature to submit.
