Sample Peer Assessment Form for Collaborative Report

Evaluator: Immah Marie R. Pineda ______________________________________Group: 12______________

Write the name of each of your group members in the columns. For each person, indicate the extent to which you agree with the statement on the
left, using a scale of 1-4:
1 - strongly disagree; 2 – disagree; 3 – agree; 4 - strongly agree
Add the numbers in each column.
Criteria Pestaño Perico Piedad Poquiz Quilaneta Raga Remorque Roque

Contributed
meaningfully to the 3 3 4 4 4 3 3 3
planning of the report
Completed assigned
work on time 4 4 4 4 4 4 4 4

Prepared work in a
quality manner
3 3 4 4 4 3 4 3

Demonstrated a
cooperative and 4 4 4 4 4 3 4 4
supportive attitude

Contributed
significantly to the 4 4 4 4 4 4 4 4
success of the report

TOTAL (Max score of

20)
18 18 20 20 20 17 19 18
Feedback on group dynamics:

The group is very organized and communication are intact. Everyone participated and gave a quality output which made the case analysis
successful.