Text Only 

Record of Evaluation for Tenured Faculty Member 

Faculty Member Name:  ______________________________________________ 

Department: ________________________________________________________ 

Department Evaluation Committee Members:  ___________________________ 

___________________________________  _______________________________ 

___________________________________  _______________________________ 

___________________________________  _______________________________ 

Department Chairperson: ____________________________________________ 

Classroom Observations (One observation per semester by the Department Committee and an evaluation per year by the Department Chairperson – see attached chart) 

Date: _____________                                    Date: ______________ 

Class: ___________________________       Class: ___________________________ 

Observer: ________________________      Observer: ________________________ 

Student Evaluations 

Course(s) Taught:  

Fall: ____________________________        _________________________________ 

________________________________        _________________________________ 

_____ Student Evaluation summaries for all fall semester courses attached 

_____ Student Evaluation summaries for some fall semester course(s) attached 

_____ No Student Evaluation summaries attached 

If missing some or all student evaluation summaries explain reason: 

Evaluation Report 

_____ 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 the 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 provided 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