<p> SCIENCE FACULTY EVALUATION FORM For Health Professions Students</p><p>PLEASE RETURN BY MAY 1 TO: Pre-Professional Office Cailín Pachter at [email protected] </p><p>TO THE STUDENT: Please complete all information before submitting electronically to your science faculty member.</p><p>STUDENT NAME______CLASS YEAR ______</p><p>MAJOR 1______MAJOR 2______MINOR ______</p><p>FACULTY NAME______DEPARTMENT ______</p><p>COURSES TAKEN WITH THIS FACULTY MEMBER SEM/YR GRADE RECEIVED</p><p>1. ______/______</p><p>2. ______/______</p><p>3. ______/______</p><p>STUDENT INTEREST: Medical______Dental______Podiatry______Optometry______</p><p>WAIVER OF RIGHTS I waive my rights to review this evaluation that I have requested, providing that it be used solely for my application to professional school.</p><p>STUDENT______DATE ______</p><p>TO THE FACULTY MEMBER: The above named student (or former student or alumnus of Muhlenberg College) requests an evaluation letter from you. This will become an important part of his or her recommendation package being sent to the health professions schools.</p><p>Please complete the second page of this form and return it to the HPO. Compose electronically with your comments in a WORD document and email them in an attachment to: [email protected] with the subject line of HPOeval Student name. Before sending your completed evaluation, click options, return receipt and then send. This will be your confirmation. </p><p>Thank you for your valuable contribution to this student’s application.</p><p>4/6/2018 FACULTY______DATE ______</p><p>EVALUATION FORM</p><p>Faculty Member: As one familiar with characteristics of this student’s work, please state your opinion regarding the following (use “X” marks please.)</p><p>TOP 2% TOP 5-10% TOP 25% TOP 50% BOTTOM 50% STUDENT CHARACTERISTICS OUTSTANDING EXCELLENT GOOD FAIR POOR OMIT</p><p>Maturity</p><p>Work habits/Initiative Motivation</p><p>Communication skills Self expression</p><p>Ability to get along and work well with others</p><p>Intellectual independence Creativity/Inquisitiveness</p><p>Laboratory Skills Technical Competence</p><p>RECOMMENDATION – Please insert an “X” next to the appropriate category.</p><p>___RECOMMENDED VERY HIGHLY: These individuals have demonstrated an outstanding potential and should be categorized as no less than “Excellent” in any of the above.</p><p>___RECOMMENDED HIGHLY: These individuals have demonstrated personal qualities and/or intellectual ability that make them well above average candidates. Students should be categorized as no less than “Good” in any of the above.</p><p>___RECOMMENDED: These individuals have demonstrated potential which would enable them to successfully complete training at the average level for that profession.</p><p>___RECOMMENDED WITH RESERVATIONS: 1) These individuals have demonstrated the personal qualities that warrant their training but their academic record is not as good as those of individuals in the previously cited categories OR 2) These individuals have demonstrated academic strength but do not possess the personal qualities that warrant their training.</p><p>___NOT RECOMMENDED: These individuals have not demonstrated the intellectual ability nor the personal qualities that would warrant their training.</p><p>COMMENTS: </p><p>Evaluations depend greatly upon the information received from science instructors. Therefore, your comments are necessary in composing a letter of recommendation and will be greatly appreciated. Please consider using the AAMC’s “Guidelines for Writing a Letter of Evaluation for a Medical School Applicant” when composing your comments. </p>