Gluck Fellows Program of the Arts
University of California, Riverside
2015-2016
EVALUATION FORM
Mosaic Fellows
Thank you for your participation in the Gluck Program. As part of our on-going evaluation of the program, we ask that you
submit an evaluation form no later than TWO WEEKS after the completion of your project to the Gluck Office (INTN –
M1016). It is advised that you also keep a copy for your records. The Gluck Program must receive this evaluation form
before we can process the disbursement of your fellowship.
SELF-EVALUATION
Fellow’s Name
Fellowship Department Creative Writing
Total number of sessions _______ Total Audience Reached:______ Number of Likes/friends on Facebook:
Please describe your outreach project. Please list each activity and your role.
How has being a Gluck Fellow affected you, your education or your research?
Please describe the demographic reach of submissions and participations.
Specific feedback or comments you heard about your project from participants:
Do you have any anecdotes or particular observations that capture the value of your work with your participants?
How will you use what you learned from this project, and communicate it to the next cohort?
The Gluck Foundation is interested in supporting UCR students who have a ‘disadvantaged’ background. If you would like,
please let us know about your background.