Application Form—Directory of Evaluators


Please take a few minutes to complete and submit this application form. Use the Tab key, NOT Enter, to move between fields.
(Note that the information you submit will be searchable from the Directory Web site.)
We may contact you prior to posting your directory information in order to clarify information you provide.


Section A

Please indicate whether you are registering personally or for your organization.

  Individual
  Organization/Institution
         If registering an organization, please provide the organization name:  
Application of  Joint Committee Standards for Educational Evaluation
    Check if you apply the Program Evaluation Standards
    Check if you apply the Personnel Evaluation Standards
    Check if you apply the Student Evaluation Standards
  Years of experience in evaluation

Section B
Contact Information  (Contact person's name if for an organization)
First Name:  
Middle Initial:  
Last Name:  
Gender:      [Optional]
Race/ethnicity:      [Optional]
List languages and proficiency levels:      [Optional]
Institution/Employer:      [Optional]
Your Title:  
Courtesy Title:     (e.g., Dr, Mr, Ms)
Address (50 characters per line):  

City:  
Country (choose one):     USA   Other
(Provide country name   
ONLY when NOT USA):  
State or territory  IF in the USA:  
Postal (zip) code:  
Phone:  
Extension (if any):  
Fax:  
Email:     Required
(Please enter only one email address)
Confirm email:  
(To insure accuracy of email address, please reenter it.)
Homepage URL (if applicable):  

Section C
(Omit this section if you are completing this form for an Organization)
Educational History
List up to  three academic degrees
(e.g., B.A. Western Michigan University 1975 Elem. Ed.)
  Highest Degree

Section D
(Omit this section if you are completing this form for an Organization)
Employment Options
Please indicate the type of organization in which you are currently employed (select one):
  College/University   Federal Agency
  Local Agency
  Non-profit
  Private Business
  State Agency
  School system
  Other  (Please specify):  
 
Discipline Area
Please indicate the primary discipline in which you work (select one)
Psychology Agriculture
Anthropology
Business/Commerce
Economics
Education
Evaluation
History
Organizational Development
Philosophy
Political Science
Research or Statistical Methods
Sociology
Other   (Please specify):  
 
Work Responsibility
Please indicate your major responsibility in present position (select one)
Consulting Evaluation
Management/Administration
Research
Student
Teaching
Other   (Please specify):  
 

Section E

Areas of Evaluation Specialty:  (select up to three in each category)

If in Section A you indicated that you are registering for an organization, select specialties for your organization.
Otherwise, select options to indicate your personal evaluation specialties.

Information Related to Educational Contexts
Educational Level:  (please select no more than three options)
  Adult Education   Early Childhood
  Elementary School
  High School
  Higher Education
  Middle School
  Vocational Education
 

Educational subject:  (please select no more than three options)
  Health   Language
  Math
  Reading
  Science
  Social Science
  Technology
 

Special Contexts in Education:  (please select no more than three options)
  Assessment in Higher Education   At-Risk Students
  Distance Education
  Extension Education
  Gifted Education
  Minority Issues
  Museum Education
  Personnel Evaluation
  Rural Education
  Special Education
  Systemic Change
  Urban Education
 


Evaluation Specialties
Evaluation Methodology:  (please select no more than three options)
  Cluster/Multi-level Evaluation   Collaborative/ Participatory/Empowerment
  Evaluation Use
  Needs Assessment
  Product Evaluation
  Program Theory and Theory Driven Evaluation
  Qualitative Methods
  Quantitative Methods: Theory and Design
  Teaching Evaluation
  Theories of Evaluation
 

General topics/subjects:  (please select no more than three options)
  Alcohol-Drug Abuse/Mental Health   Business and Industry
  Computer Use in Evaluation
  Crime and Justice
  Cross-Cultural
  Distance Evaluation
  Evaluation for Special Needs
  Evaluation Managers and Supervisors
  Feminist Issues
  Human Resource Development
  Human services Evaluation
  Independent Consulting
  International
  Job Training in Social Services and Industry
  Math/Science Partnership
  Media/Technology Evaluation
  Minority Issues
  Non Profits and Foundations Evaluation
  Research/Technology/Development
  Staff Development
  State and Local Government
  Training Programs
 

Other Evaluation Specialities  (Please specify):  

Section F
Additional Comments:


By submitting this form I authorize Western Michigan University to post the information provided in the online Directory of Evaluators.
  I authorize posting this information.
(Updates to existing information and some new submissions  require you to reply to an email before posting.  Watch for the email.)
  
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