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CPIN Distinguished Lecture Report & Evaluation Form

CPIN Trainees: Please fill in the below online Lecture Report & Evaluation Form as a record of your attendance to the Distinguished Lectureship Series within one week of attending the talk. Please note that the date and time of your Lecture Report Form submission is recorded. Please wait until a lecture is completed before submitting your form.

To ensure that the form has been received by us, please wait for a confirmation message upon submission. We recommend Google Chrome or Mozilla Firefox to fill the form. 

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Trainee Name:
Trainee ID Number (Students should enter their UofT Student Number; Please enter N/A if you are a Postdoc):
E-mail address:
 
Institution:
Program:
PhD
MA
MASc
MHSc
MPH
MSc
Postdoctoral Fellowship
CPIN Distinguished Lecture Speaker:
Other Speaker (NOTE: In exceptional circumstances, prior permission from the CPIN Director is required for attending neuroscience seminars other than the CPIN Distinguished Lectureship Series in order to fulfill CPIN trainee requirements):
Location:
Date:
Pick date
Lecture Title:
Please be concise; limit answers to 1-2 brief points.
1. The main focus of the lecture:
2. List the most important information that you have learned from this lecture:
3. List one question that you have asked or would like to ask the speaker:
4. What I have learned from this lecture includes: (please check all that apply to you)
a new field
a new concept
a new discovery
a new method/technique
a new application of the method/technique
a new animal model for a disease
a new or potential clinical intervention/treatment
how to ask a specific question
how to design experiments and/or validate a method
how to be critical of the results
None of the above
Other (please specify)
5. The information that I have learned from this talk can be applied to my own research:
6. The lecture was clearly delivered:
7. The lecture was inspirational:
I would like to learn more on the following topics in future:
Additional comments and suggestions:
I certify that I have personally attended this lecture & completed this form which will be kept as a record in the CPIN office
Agree
Would you like to be contacted regarding:
meeting with upcoming lecture speakers
upcoming CPIN volunteer opportunities