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					              ANNUAL EVALUATION FORM FOR GAANN BIOTECHNOLOGY FELLOWS

Please attach a copy of the Fellow’s Plan of Graduate Work to this form. If the Fellow has not yet developed a plan of graduate
work, then an “informal” plan of graduate work should be attached. This “informal” plan of graduate work will not be submitted to
Graduate School Records. It will be used by the Selections Committee to determine if the Fellow is meeting/will meet all of the
academic requirements of the fellowship program. In addition, the fellow should attach a single page summary of his or her research
with an explanation of how it is related to biotechnology.

    NAME OF FELLOW__________________________________ STUDENT ID NUMBER__________________


    DEPARTMENT ______________________________________

    MAJOR_________________________                       MINOR___________________________

    NAME OF ADVISOR_________________________________

    GRADUATE ADVISORY COMMITTEE APPOINTED _____YES _____NO

    MEMBER OF GAANN BIOTECHNOLOGY
    COMMITTEE REPRESENTED ON FELLOW’S
    GRADUATE ADVISORY COMMITTEE:                                    ________________________________

    PLAN OF WORK FILED _____YES                 _____NO

    DATE ENTERED OR WILL ENTER DOCTORAL PROGRAM AT NC STATE______________

    DATE EXPECTED TO COMPLETE PHD________________

    SEMESTERS IN WHICH THE FELLOW PARTICIPATED IN OR   SEMESTER 1______
    PLANS TO PARTICIPATE IN THE TWO SEMESTER PREPARING
    THE PROFESSORIATE PROGRAM                          SEMESTER 2______

    CUMULATIVE GPA__________


    RESEARCH TOPIC_________________________________________________________________________

    __________________________________________________________________________________________


    PLEASE ANSWER THE FOLLOWING FOR THE ENTIRE PERIOD OF APPOINTMENT AS A
    GAANN FELLOW:

    1) Complete citations of papers published or submitted for publication; titles, locations and dates of any oral
    presentations; and titles, locations and dates of posters presented:

    __________________________________________________________________________________________

    __________________________________________________________________________________________

    __________________________________________________________________________________________

    __________________________________________________________________________________________




                                                                1
       ANNUAL EVALUATION FORM FOR GAANN BIOTECHNOLOGY FELLOWS


2) Professional Meetings Attended:_______________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

3) Other Special Accomplishments_______________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

4a)    If eligible, do you recommend that this student should be reappointed to         YES_______
       a GAANN Fellowship?
                                                                                        NO________

4b)    If so, why? (Please make a brief case for reappointment of this Fellow.)

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

This Fellow is making satisfactory progress toward the degree objectives.         YES_______

                                                                                  NO________


__________________________________________________                      ______________
SIGNATURE OF FELLOW’S ADVISOR                                   DATE

__________________________________________________                      ______________
SIGNATURE OF DIRECTOR OF GRADUATE PROGRAMS                              DATE

---------------------------------------------------------------------

RECOMMENDED FOR RENEWAL BY FELLOWSHIP COMMITTEE? YES_______ NO________


______________________________________________________                            ______________
SIGNATURE AND TITLE OF COMMITTEE REPRESENTATIVE                                   DATE


5/08




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