CSIN 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. 

Page 1 of 1
Trainee Name: Trainee ID Number (Students should enter their UofT Student Number; Please enter N/A if you are a Postdoc): E-mail address:  Enter a valid email address. Example: name@company.com Institution: Program: PhD MA MASc MHSc MPH MSc Postdoctoral Fellowship CPIN Speaker: Dr. Steven LavioletteDr. Juan SongDr. Mark TuszynskiDr. Weihong SongDr. Bo LiDr. Amar SahayDr. Carol MarchettoDr. Ivan SoltezI have permission from the CPIN Director to attend a seminar by the speaker below 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: 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: Directly ApplicableNeutralNot Directly Applicable 6. The lecture was clearly delivered: Clearly DeliveredNeutralNot Clearly Delivered 7. The lecture was inspirational: Highly InspirationalNeutralNot 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