SELF APPRAISAL FORM

Name__________________________________  

College____________________________

Department/Division_______________________  

Date Submitted_____________________

Please respond briefly with specific examples to the following statements and questions.  Responses should be typed and the document should be no more than two pages.

1.  List your professional goals for teaching and learning, and how have you achieved them in the past three years.

2.  List the professional, community, and college activities (consistent with the mission of the college) that you have been involved in during the past three years.

3.  List your professional goals (institutional, community, and instructional) for the next three years and state how you plan to achieve them.

4.  What have you done to create a challenging and stimulating teaching/learning environment for your students?
	Have you introduced new instructional approaches?
	Have you individualized instructional techniques and approaches to meet 			the diverse needs and abilities of my students?
	Have you developed and/or revised course materials?