ANNUAL EVALUATION FORM FOR GAANN BIOTECHNOLOGY FELLOWS
Please attach a copy of the Fellow’s Plan of Graduate Work to this form. If the Fellow has not yet developed a plan of graduate
work, then an “informal” plan of graduate work should be attached. This “informal” plan of graduate work will not be submitted to
Graduate School Records. It will be used by the Selections Committee to determine if the Fellow is meeting/will meet all of the
academic requirements of the fellowship program. In addition, the fellow should attach a single page summary of his or her research
with an explanation of how it is related to biotechnology.
NAME OF FELLOW__________________________________ STUDENT ID NUMBER__________________
DEPARTMENT ______________________________________
MAJOR_________________________
MINOR___________________________
NAME OF ADVISOR_________________________________
GRADUATE ADVISORY COMMITTEE APPOINTED _____YES _____NO
MEMBER OF GAANN BIOTECHNOLOGY COMMITTEE REPRESENTED ON FELLOW’S
GRADUATE ADVISORY COMMITTEE:
________________________________
PLAN OF WORK FILED _____YES
_____NO
DATE ENTERED OR WILL ENTER DOCTORAL PROGRAM AT NC STATE______________
DATE EXPECTED TO COMPLETE PHD________________
HOW DOES THE FELLOW PLAN TO FULFILL THE SUPERVISED TEACHING REQUIREMENT (Please
refer to the document at http://www.ncsu.edu/grad/financial-support/docs/GAANNSupervisedTeachingOptionsBiotech.pdf for options):
____ OPTION 1 (FIT + TA)
____ OPTION 2 (COAT)
____ OPTION 3 (PREPARING THE PROFESSORIATE)
SEMESTERS IN WHICH THE FELLOW FULFILLED OR
PLANS TO FULFIL THE TWO SEMESTER SUPERVISED
TEACHING REQUIREMENT
SEMESTER 1______
SEMESTER 2______
CUMULATIVE GPA__________
RESEARCH TOPIC_________________________________________________________________________
__________________________________________________________________________________________
PLEASE ANSWER THE FOLLOWING FOR THE ENTIRE PERIOD OF APPOINTMENT AS A
GAANN FELLOW:
1) Complete citations of papers published or submitted for publication; titles, locations and dates of any oral
presentations; and titles, locations and dates of posters presented:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
1
ANNUAL EVALUATION FORM FOR GAANN BIOTECHNOLOGY FELLOWS
2) Professional Meetings Attended:_______________________________________________________________
__________________________________________________________________________________________
3) Other Special Accomplishments_______________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
4a)
If eligible, do you recommend that this student should be reappointed to
a GAANN Fellowship?
YES_______
NO________
4b)
If so, why? (Please make a brief case for reappointment of this Fellow.)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
This Fellow is making satisfactory progress toward the degree objectives.
YES_______
NO________
__________________________________________________
SIGNATURE OF FELLOW’S ADVISOR
______________
DATE
__________________________________________________
SIGNATURE OF DIRECTOR OF GRADUATE PROGRAMS
______________
DATE
--------------------------------------------------------------------RECOMMENDED FOR RENEWAL BY FELLOWSHIP COMMITTEE? YES_______ NO________
______________________________________________________
SIGNATURE AND TITLE OF COMMITTEE REPRESENTATIVE
11/10
2
______________
DATE