Evaluation Form
Electronic Request Form
USER INFORMATION
(To be filled out by user.)
Faculty Member
First Name
Last Name
Division
Business and Technology
Liberal Arts
Natural Sciences
Health, Social and Behavioral Sciences
Library
Counseling
Office Location
Telephone Ext.
E-mail Address
Existing Computer System
Windows or
Macintosh
Provide FTAC with the information requested below. Forward any copies of reviews or advertisements that you believe are necessary for evaluating this proposal to Joe Miragliotta, Chair FTAC, SRC 2001.
Type of Proposal Funded
Faculty Development
Hardware
Software
Office System
Provide a brief description of the proposal items or activity
Overall Assessment
Beneficial to me as an instructor
Beneficial for my students
Not beneficial to me as an instructor
Not beneficial for my students
Provide the outcomes (both positive and/or negative) that mini-grant has provided for enhancement and support of instruction in the box below.