Course Evaluation Request Pitzer course evaluation request forms for the current semester. Submit up to four course evaluations at one time. Please contact the Office of the Dean of Faculty for questions and further assistance. * denotes required information. Course Evaluation Request Name* First Last Email* PhoneCourse Code and Number* Course Section Number* Course Title Date to release evaluation* MM slash DD slash YYYY Please enter the day you would the course evaluation sent. NOTE: Same day processing not availableTime to release evaluation (PDT) : HH MM AM PM Please enter the time you would the course evaluation sent. If not selected, default will be 8:00am.Preferred FormCourse Evaluation Form Templates. Preview available sample templates with following links: Form A Form B Form C Form D Supplemental Questions Select Form*Select one or more forms. Please provide additional questions or instructions below or via file upload. Form A Form B Form C Form D Supplemental Questions to A/B/C/D Custom Additional Instructions or NotesUpload FileUpload custom form or additional questions, if any, to existing form. Word and PDF formats accepted. Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, png, tif, , Max. file size: 50 MB. 2nd Course Evaluation? Yes No Request 2: Course Code and Number* Request 2: Course Section Number* Request 2: Course Title Request 2: Date to release evaluation* MM slash DD slash YYYY Please enter the day you would the course evaluation sent.Request 2: Time to release evaluation (PDT) : HH MM AM PM Please enter the time you would the course evaluation sent. If not selected, default will be 8:00am.Request 2: Select Form*Select one or more forms. Please provide additional questions or instructions below or via file upload. Same form as first request? Form A Form B Form C Form D Supplemental Questions to A/B/C/D Custom Request 2: Additional Instructions or NotesRequest 2: Upload FileUpload custom form or additional questions, if any, to existing form. Word and PDF formats accepted. Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, png, tif, , Max. file size: 50 MB. 3rd Course Evaluation? Yes No Request 3: Course Code and Number* Request 3: Course Section Number* Request 3: Course Title Request 3: Date to release evaluation* MM slash DD slash YYYY Please enter the day you would the course evaluation sent.Request 3: Time to release evaluation (PDT) : HH MM AM PM Please enter the time you would the course evaluation sent. If not selected, default will be 8:00am.Request 3: Select Form Format*Select one or more forms. Please provide additional questions or instructions below or via file upload. Same form as first request? Form A Form B Form C Form D Supplemental Questions to A/B/C/D Custom Request 3: Additional Instructions or NotesRequest 3: Upload FileUpload custom form or additional questions, if any, to existing form. Word and PDF formats accepted. Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, png, tif, , Max. file size: 50 MB. 4th Course Evaluation? Yes No Request 4: Course Code and Number* Request 4: Course Section Number* Request 4: Course Title Request 4: Date to release evaluation* MM slash DD slash YYYY Please enter the day you would the course evaluation sent.Request 4: Time to release evaluation : HH MM AM PM Please enter the time you would the course evaluation sent. If not selected, default will be 8:00am PDT.Request 4: Select Form*Select one or more forms. Please provide additional questions or instructions below or via file upload. Same form as first request? Form A Form B Form C Form D Supplemental Questions to A/B/C/D Custom Request 4: Additional Instructions or NotesRequest 4: Upload FileUpload custom form or additional questions, if any, to existing form. Word and PDF formats accepted. Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, png, tif, , Max. file size: 50 MB.