\documentclass[11pt]{article}

\usepackage{xspace}
\usepackage{amssymb}
\addtolength{\textwidth}{1.70in}
\addtolength{\textheight}{1.20in}
\addtolength{\evensidemargin}{-1.5in}
\addtolength{\oddsidemargin}{-0.5in}
\addtolength{\topmargin}{-1.4in}

\begin{document}
\pagestyle{empty}
\noindent
{\large \bf TA Evaluation Form}\hfill Name of TA:\underline{\hspace*{2.5in}}

\vspace*{5mm}
\noindent  
Course:\underline{\hspace*{2in}}\hfill Quarter/Year:\underline{\hspace*{1.5in}}

\vspace*{5mm}
\noindent 
This questionnaire is used to provide confidential feedback to the TA on 
his/her teaching effectiveness.  What will make this form useful to the TA
is if you are completely honest in your responses, and give sufficient detail.

\begin{enumerate}
\item Was the TA accessible to you outside of class?  Did you attend office 
hours, and if so, was that time useful to you? 
\vspace*{1.8in}
\item How well does the TA integrate the discussion section with the overall
course objectives?
\vspace*{1.8in}
\item Was the TA prepared for class?  Was the TA organized? Did the TA explain
the material clearly?

\vspace*{2.4in}
\hspace*{1.4in}{\bf Please complete items 4-6 as well.} 
\item What did you particularly like about this section and/or TA? 
\vspace*{2.8in}
\item What did you not like, and how might improvement be made?
\vspace*{2.8in}
\item Please write any additional comments below.
\end{enumerate}

\end{document}