Carolina Institute for the Multicultural Approach to Science

Teacher Evaluation Form

To the evaluator: The proper selection of students to this Research Internship Program is of significance not only to the Selection Committee, but to the Carolina Institute for the Multicultural Approach to Science and the Burroughs-Wellcome Fund. In order to be fair to all applicants we need as much information as possible. It is our experience that the evaluation which is most helpful to the Selection Committee is one which includes statements concerning the student's possible deficiencies as well as strengths. This form is due by May 1, 2002.

You may submit this form electronically. You must include your email address and telephone number so that we can confirm your submission of this evaluation. If you have questions or concerns send e-mail to: powellw@lrc.edu

go to the online Student Application Form
go to the CIMAS program Description
see other Hands-on Science opportunities for Students in North Carolina
go to the Student Science Enrichment Program Main Page

• 1 = Below Average
• 2 = Average
• 3 = Above Average
• 4 = Excellent
• 5 = Outstanding

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  Applicant's Name:
  

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  Intellectual Ability 1 2 3 4 5	Academic Strength 1 2 3 4 5
  Communication Skills 1 2 3 4 5	Leadership 1 2 3 4 5
  Quality of Written Expression 1 2 3 4 5	Comprehension 1 2 3 4 5
  Retention 1 2 3 4 5	Applies Knowledge 1 2 3 4 5
  Energy and Initiative 1 2 3 4 5	Ability to Work Independently 1 2 3 4 5
  Social Maturity 1 2 3 4 5	Self-Confidence 1 2 3 4 5
  Dependability 1 2 3 4 5	Disciplined Work Habits 1 2 3 4 5
  Achievement in Relation to Potential 1 2 3 4 5

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  In which courses have you taught the student?

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  How well do you know the applicant?

  
  

  What is the student's standing in the course?

  Outstanding (top 5%)

  Very good (next highest 10%)

  Average (at or above the mean)

  Below average (below the mean)

  Not Applicable

  I_______this student:

  Strongly Recommend

  Recommend

  Do not Recommend

  Explain:

  Name of Evaluator	Title/Institution
  Phone Number	Email address (necessary for confirmation)

  Additional comments or questions:

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  Dr. Wayne Powell, CIMAS Program Director may be contacted at:

  powellw@lrc.edu

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