Carolina Institute for the Multicultural Approach to Science

Teacher Evaluation Form

**NOTE: This application form is for North Carolina residents only.**

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


Please rank this student in the appropriate sector with the characteristics below. Use the following ranking system:
  • 1 = Below Average
  • 2 = Average
  • 3 = Above Average
  • 4 = Excellent
  • 5 = Outstanding
    Applicant's Name:

    Intellectual Ability
    Academic Strength
    Communication Skills
    Leadership
    Quality of
    Written Expression

    Comprehension
    Retention
    Applies Knowledge
    Energy and Initiative
    Ability to Work
    Independently

    Social Maturity
    Self-Confidence
    Dependability
    Disciplined
    Work Habits

    Achievement in Relation
    to Potential


    In which courses have you taught the student?


    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:


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

    powellw@lrc.edu



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