1.Student Name

First Name

Last Name

2.Course Subject (i.e. CHEM)

3.Course Number (i.e. 201)

4.Professor / Instructor Name

5.Professor / Instructor Email

6.Professor / Instructor Phone Number

7.Please rate the student in the following areas:

Very Good

Good

Fair

Poor

Very Poor

Not Applicable

Class Participation

Very Good

Good

Fair

Poor

Very Poor

Not Applicable

Attendance

Very Good

Good

Fair

Poor

Very Poor

Not Applicable

Assignments

Very Good

Good

Fair

Poor

Very Poor

Not Applicable

8.What are the average grades, if applicable?

Homework

Papers

Quizzes

Tests

9.What is the student's overall grade?

10.Does the student need any type of assistance?

Yes

No

Unsure

11.Do you have any suggestions and / or general comments to add?