Faculty Member                                                          Academic Year                       

 Purpose of this evaluation:

                  annual (          year of full-time, continuous employment; e.g. 4th)







DIRECTIONS TO THE ILS: The conference participants must review and discuss the following components of this faculty member's evaluation, together with other aspects of current job performance the members of the conference deem appropriate and relevant:

            !         Evaluatee's Form A-1 commentary

            !         Recipients of service evaluations

            !         Supervisory observation evaluation(s)

            !         ILS's Form A-2 commentary response

          !         Faculty rebuttal(s) or appropriate peer reviews

          !         If relevant, assessment of degree to which faculty member has met any previously stated objectives and evaluation recommendations

The ILS must write a summary of the evaluation conference and identify areas of job performance that may need improvement. (This assessment must be typed. Attach extra sheets as needed.)  Upon completion of Form D-1, send the original and a copy to the Central File with copies to all evaluation conference participants. 

__________________                                                                                                _____________
Faculty Member                                   Date                             ILS                              Date 

Coordinator or Peer                             Date                             Dean                            Date

The faculty member should initial this line if he or she disagrees with the evaluation conference summary.