Mid-Semester Evaluation & Observation Request Form
Please fill out the form below to request our services. One of our staff will be in contact with you by email within
the next few days. Mahalo.

**Please note that Small Group Instructional Diagnosis is only available in March and October.
For Pencil & Paper, please paste http://www.cte.hawaii.edu/PandP.html into your web browser.
Type of Evaluation *
Please select: *
Email *
(an email address where we can reach you)
Your answer
Department *
Your answer
Number of Students *
Your answer
Days/hours of Your Class *
example: MWF 12:00-12:50pm
Your answer
Location of Class *
example: KUY 201
Your answer
Course Number *
example: PSY 402
Your answer
Course Name *
example: History of Psychology
Your answer
Select your preferred date and time for a classroom visit by CTE Consultant
While filling out this section, please select two dates and times in order of preference. We will do our best to accommodate your first preference.
First Choice Date: *
Please select your first preferred date
MM
/
DD
/
YYYY
First Choice Time: *
Please select a time for the above date
Time
:
Second Choice Date: *
Please select your second preferred date
MM
/
DD
/
YYYY
Second Choice Time: *
Please select a time for your second preferred date
Time
:
Your Last Name *
(family)
Your answer
First Name *
(given)
Your answer
Telephone Number *
(a phone number where we can reach you)
Your answer
Notes
Your answer
Submit
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