Human Resources - Evaluation

Complete this form to request a replacement course evaluation packet for your class. Provide as much information as possible to ensure that your request is handled as efficiently as possible.

  • Make sure to put a valid ACC email address; the form will not be submitted without a valid email address.
  • In the comments section, please indicate the semester.

Please submit one request per class.
Before you submit, please go to our calendar to check the deadlines to request replacement packets.  Please note that deadlines are specific to the course duration as defined by start date and end date:

Faculty Evaluation Calendar


* Indicates required field.

 Instructor Information

Last Name


First Name


Datatel ID


Course Information

Course Title

Course Number

Course Synonym

* (One per form)

Number Enrolled

Session Length

(ex. 8 week, 16 week, etc.)

Location of Class

Comments or Special Instructions
(No Course Synonms)





Requestor Information

Requestor Name


E-mail Address


Daytime Phone


Alternate Phone