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Evaluation Form for Full Proposals
Hartford Centers of Geriatric Nursing Excellence
Section 1:
Reviewer’s Name:
Reviewer’s Email Address:
Date of Review: MM/DD/YYYY
Applicant Organization:
Program Director:

Summary: numbers and levels of nurses proposed to be prepared as geriatric nursing faculty:
MS Graduates:
PhD's:
DNP's:
Other: Specify:
Plans for Match:

Section 2
Instructions: Please rate the proposal on the indicators listed below using response options ranging from 1 (very weak) to 5 (very strong).  If you do not have sufficient information to rate a specific criterion, check the box for “unable to assess.”  The overall strength of the proposal is intended as a separate, general rating; it is not intended to be scored as an average or sum of the other categories.

Please complete the comments section that follows the table.  It is important to include sufficient comments to help guide discussion about the proposal and develop a consensus rating.
Summary Review Form Very Weak Very Strong Unable to Assess
Selection Criteria 1 2 3 4 5 6
1. Likelihood that the Center will be successful in preparing larger numbers of expert faculty committed to long-term careers in geriatric nursing (e.g., past success in this area, nature of the curricula and program material).
2. Inclusion of clearly quantifiable objectives.
3. Innovation in the design and methods used to meet the clearly quantifiable objectives.
4. Strength of the proposed program director’s credentials in relation to the proposed center’s activities.
5. Strength of the school and faculty in relation to preparation of expert educators in geriatric nursing.
6. Strength of existing programs in preparing geriatric nursing faculty.
7. Evidence that graduates will be committed to a long-term career in geriatric nursing.
8. Logic underpinning how the proposed programs will build on existing programs in geriatric nursing.
9. Degree to which the plans provide additional distinct contributions beyond existing efforts.
10. Adequacy of the resources and environment to support program goals.
11. Potential for sustainability of the program beyond this grant funding
12. The management plan, including the management structure, plan for use of fiscal resources, organization and coordination of personnel.
13. Appropriateness of the budget in relation to the proposed activities.
14. Strength of the $500,000 match.
15. Creative partnerships contributing to the required match.
16. Overall strength of the proposal: (Need not be sum of items above)

Please provide specific comments to explain the overall and specific ratings for this proposal.  It is important to include sufficient comments to help guide discussion about the proposal and develop a consensus rating.

The main strengths of this proposal are:

The main weaknesses of this proposal are:
Do you recommend this application for funding? No Yes Maybe