360° (Mid Review) Evaluators Selection Form

Using this form please identify from fifteen to thirty (15-30) individuals you recommend as your 360° evaluators.

Your Information
Enter the name and title of the subject (senior leader) being evaluated.
Your Name*
The name of the subject being evaluated.
First Last
Your Job Title*
The job title of the subject being evaluated.
Evaluators Information
Fill out the required information for each of your fifteen to thirty (15-30) selected evaluators.
Raters should be individuals with whom the senior leader being reviewed generally interacts in conducting the unit’s business. This group may include
- Direct Reports
- Staff Representative(s)
- Faculty Representative(s)
- Student Representative(s)
- Community Member(s)
- External Constituents
Evaluator Information*
Please enter the full name, title, email address, brief reason for selection, and relationship to the subject being evaluated. For example: (Name) Butch Cougar, (Title) Mascot Extraordinaire, (Email) butchtcougar@wsu.edu, (Reason for Selection) Several joint projects focused on promoting WSU, (Relationship Category) Peer.
First Name Last Name Title Email Reason for Selection Relationship Category

First Name	Last Name	Title	Email	Reason for Selection	Relationship Category

Your Information