Faculty and Staff Resources

EOPS Form

Dear Faculty Member:
Please assess EOPS/CARE/MCP students taking your classes, when requested, using this form.

In order to maintain eligibility, a periodic evaluation has to be made to determine whether EOPS/CARE/MCP students are attending classes and making satisfactory progress. To initiate an accurate assessment and take appropriate action, we ask for your cooperation. Your feedback and/or suggestions are very important. If you find that the student's status is not addressed by this form, please call the EOPS Department at ext. 7207.

All required fields are listed in Red

Student Information -

* Student Name:

* Student ID Number:

(8 digits, use no dashes)

Quarter:

Summer Fall Winter Spring

Academic Year:

*Course name & number:

*Units:

Which Evaluation:

First Second

Rate the student's performance using the codes and sub-codes (below).

Codes		Sub-Codes
	Excellent		Recommend as tutor	Failing performance on exams
	Above Average		Attending regularly/no grade yet	Recommend tutoring
	Average		Irregular Class Attendance	Lacks preparation of assignments
	Below Average		Refer to counselor	Must take prerequisite classes
	Failing		Incomplete assignments	Other:

Comments or suggestions?

Faculty / Staff Information -

* Instructor Name:

* Your Department:

* Contact Phone:

* Contact eMail:

Form Validation -

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to listen to a phrase.

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