Text Only 

Record of Evaluation for Tenure Track Faculty Member 

Faculty Member Name:  ______________________________________________ 

Department: ________________________________________________________ 

____ Fall Hire            _____ Spring Hire 

Evaluation Year:  _____ 1^st _____ 2^nd _____ 3^rd _____ 4^th _____ 5^th 

Department Evaluation Committee Members:  ___________________________ 

___________________________________  _______________________________ 

___________________________________  _______________________________ 

___________________________________  _______________________________

Department Chairperson: ____________________________________________ 

Classroom Observations (2 peer observations per semester for semesters evaluated and one chairperson observation per year – see attached chart) 

Date: _____________                                    Date: ______________ 

Class: ___________________________       Class: ___________________________ 

Observer: ________________________      Observer: ________________________ 

____  Observation report shared with faculty member   ____  Observation report shared with faculty member 

____  Observation report attached                                     ____  Observation report attached 

Date: _____________                                    Date: ______________ 

Class: ___________________________       Class: ___________________________ 

Observer: ________________________      Observer: ________________________ 

____  Observation report shared with faculty member   ____  Observation report shared with faculty member 

____  Observation report attached                                     ____  Observation report attached 

Student Evaluations 

Course(s) Taught: 

Fall: ____________________________        Spring: __________________________ 

________________________________        _________________________________ 

________________________________        _________________________________ 

________________________________        _________________________________ 

_____ Student Evaluation summaries for all courses attached 

_____ Student Evaluation summaries for some course attached 

_____ No Student Evaluation summaries attached 

If missing some or all student evaluation summaries explain reason: 

 Evaluation Reports 

_____ Committee Report shared with faculty member 

_____ Committee Report attached 

_____ Committee Report sent to chair with copy to Dean by deadline (see attached deadline chart)

 _____ Department Chair Report shared with faculty member with copy to Department Committee 

_____ Department Chair Report attached 

_____ Department Chair Report sent to Dean by deadline (see attached deadline chart)

 _____ Dean’s Report shared with faculty member; final report to Department Committee and              Department Chair 

_____ Dean’s Report attached 

_____ Dean’s report sent to Provost by deadline (see attached deadline chart)

 ________________________________________________________        ________________

Department Evaluation Chair Signature                                                      Date 

________________________________________________________        ________________

Department Chair Signature                                                                         Date 

________________________________________________________        ________________

Deans Signature                                                                                            Date