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Request Information

(xxx-xxx-xxxx)

Faculty Student Evaluation of Instruction Survey Course Request

(name.#)
Course Listings (Core)
Course Listings (Elective)
Please provide the course Department (VM, VCS, VPM, VBS), Course Number, and Course Title.

Elective Evaluation Form

Please provide the name of the student who completed the elective experience.
Please provide the name of the location/practice where the student completed the elective experience.
Please provide the date the student began their elective experience.
Please provide the date the student ended their elective experience.
Please provide the name of the advisor who supervised the student during their elective experience.
Please provide a grade you believe the student achieved during their elective experience.
Students will receive a copy of their evaluation.
(xxx) xxx-xxxx
Please provide a telephone number where you may be reached regarding these evaluation comments, if necessary.
Please provide an email address where you may be contacted regarding these evaluation comments, if necessary.

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