\documentclass[10pt]{article}

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\begin{tabular}[c]{p{1.5in}|p{2.6in}|p{2.6in}|}%
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& \makebox[2.6in]{Strengths} & \makebox[2.6in]{Suggestions for improvement} \\ \cline{2-3}
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\begin{document}

\begin{flushright}
\noindent
{\bf\sc Teaching Assistant Evaluation Form} \hfill
TA name: \underline{\hspace{4cm}}

\noindent Class number: \underline{\hspace{4cm}}

\end{flushright}

% \vspace{3mm}

Teaching assistants contribute significantly to the instructional
program at Stanford.  Many teaching assistants will do it again, and
will become instructors at other colleges and universities in the
future, and could benefit significantly from an assessment of their
teaching performance.  Please respond candidly to the following
questions.  After the grades have been turned in to the registrar,
these evaluation sheets will be given to the teaching assistant, and
will not be used for any other purpose.  You are particularly
encouraged to offer constructive suggestions that may help to improve
the effectiveness of the teaching assistant.

If you would like to comment on several teaching assistants, please
fill in one evaluation form per teaching assistant.

%\vspace{1cm}

\begin{center}

\vspace{3mm}

{\it Please tell us about you}

\vspace{3mm}

\noindent
Major: \underline{\hspace{4cm}} \hfill 
Year: \begin{tabular}{|c|c|c|c|c|c|}
\hline Fresh Soph Junior Senior MS PhD \\ \hline \end{tabular} \hfill
Years at Stanford: \underline{\hspace{4cm}}

\vspace{3mm}

{\it Please estimate the amount of interaction you had with your
teaching assistant}

\vspace{3mm}

Number of sections attended: \underline{\hspace{7mm}} \hspace{1mm}
Number of office hours attended:  \underline{\hspace{7mm}} \hspace{1mm}
Number of e-mail exchanges:  \underline{\hspace{7mm}}

\vspace{3mm}

{\it Please fill in one diamond for each question
(N/A means ``not applicable'')}

\vspace{3mm}

\begin{questlist}
\quest{Knows subject material}
\quest{Gives clear explanations}
\quest{Imparts enthusiasm for the subject}
%\quest{Helped develop your thinking skills}

\quest{Is well prepared for section}
\quest{Sets the pace of sections appropriately}
%\quest{Avoids being sidetracked}
%\quest{Selects good examples}
%\quest{Creates good section handouts}

\quest{Has office hours at a convenient time}
\quest{Is well prepared for office hours}
\quest{Answers questions clearly and promptly}

%\quest{Provides helpful hints on assignments}
\quest{Grades fairly}
\quest{Writes useful comments on homeworks}

\quest{Is available when you have special needs}
\quest{Overall performance}

\end{questlist}

\vspace{3mm}

{\it Please give constructive comments on the following topics, \\
that may help the teaching assistant to improve his/her effectiveness}

\vspace{3mm}

\begin{commlist}
\comm{Conduct of section}
\comm{Conduct of office hours}
\comm{Attitude towards students}
\comm{Knowledge and presentation of the material}
\comm{Overall performance}
\end{commlist}

\end{center}

\end{document}




