Teacher Education Interview Rating Form for Faculty Interviewer
Applicant’s Name _____________________________
Applicant’s Student ID# _____________________________
Educ 208 Instructor’s Name_____________________________
The candidate for admission to the Teacher Education Program at Peru State College is presenting this interview form to you to
complete as one of the requirements for entry into the program. We ask that you please take time to interview the candidate and offer
your honest appraisal by completing the form below and returning it to the Education Office at your earliest convenience.
Please complete the following assessment by circling the appropriate answer that indicates your opinion of the interviewee. You may
add comments as appropriate. Interviewer should return signed form to the Education Office.
Question Meets Standard Circle Yes or No
1. Introduction: Tell me about yourself. Able to communicate
effectively. Yes No
2. Professional Motivation: What experiences or events motivated you to Is motivated for sound
become a teacher and how motivated are you? reasons Yes No
3. Ability/Motivation to Learn: What was your most challenging subject Indicates desire to be
and how did you approach learning? challenged and continue Yes No
4. Confidence: Tell me about a situation that required a great deal of Exhibits degree of confidence
confidence on your part (taking an unpopular stand for what you believe, necessary for pursuing a Yes No
serving in a leadership role, etc.). teaching career.
5. Openness to Others: What experiences have you had with individuals Expresses openness and
from different cultures and backgrounds in school, community and work? tolerance for individual Yes No
6. Please explain your background and/or experience in your content Appropriate background for
area(s). PSC requirements. Yes No
Overall Recommendation for Admission to Peru State College Teacher Education Program:
Admit □ Should Not Admit □ Undecided □
Comments (please comment, especially if recommendation is “Should Not Admit” or “Undecided”):
We want to thank you for your contribution to this process. Your assessment of this teacher education candidate is greatly valued.
Printed Name of Interviewer ______________________________________________
Signature of Interviewer ______________________________________________ Date_____________
Interviewer: please return signed form to Education Office via campus mail.
Please note that the candidate must complete one interview with a full-time faculty member from their major
area and one interview with a full-time School of Education faculty member.
Revised February 1, 2010