Self/Team Member Assessment Form

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Write your name and the names of team members in the first column. Then, score yourself and team members by number. Name of Team Performance Beginning Developing Accomplished Exemplary Score Member Trait 1 2 3 4 Contributes by Collects some Collects a great Does not collect Collects very little Researching & basic deal of any information information-- Gathering information--most information--all that relates to the some relates to Information relates to the relates to the topic. the topic. topic. topic.

Relays a great Relays very little Relays some basic Does not relay deal of Sharing information-- information--most any information to information--all Information some relates to relates to the teammates. relates to the the topic. topic. topic.

Hands in most Hands in all Does not hand in Hands in most Being Punctual assignments on assignments on any assignments. assignments late. time. time. Name of Team Performance Beginning Developing Accomplished Exemplary Score Member Trait 1 2 3 4 Takes Responsibility by

Does not perform Performs all Fulfilling Team any duties of Performs very Performs nearly duties of assigned Role Duties assigned team little duties. all duties. team role. role.

Either contributes too little Contributes a fair information or Contributing Does not Contributes some amount of contributes During Team contribute during information--most important information that is Meetings the meetings. is relevant. information--all is irrelevant to the relevant. specific seminar topic.

Rarely does the Usually does the Always does the Always relies on assigned work-- assigned work-- assigned work Sharing Equally others to do the often needs rarely needs without having to work. reminding. reminding. be reminded. Name of Team Performance Beginning Developing Accomplished Exemplary Score Member Trait 1 2 3 4 Values Others' Viewpoints by

Listening to Monopolizes team Usually does most Listens passively Other discussions or of the talking or rather than Listens actively Teammates never speaks rarely talks actively

Sometimes Usually disagrees disagrees with Rarely disagrees with teammates teammates and with teammates Always offers Cooperating and offers no offers few and often offers constructive with Teammates constructive constructive constructive suggestions. suggestions suggestions suggestions

Usually wants to Often tolerates Always helps Making Fair Usually considers promote his/her only selected team reach Decisions all viewpoints. own viewpoints. viewpoints. consensus. Name of Team Performance Beginning Developing Accomplished Exemplary Score Member Trait 1 2 3 4 TOTAL SCORES AND COMMENTS

Brief description of the extent to which team member contributed to the Research Study:

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