CSIN Lecture Report and Evaluation Form

Trainee Name*

Trainee ID Number *

(Students should enter their UofT Student Number; Please enter N/A if you are a Postdoc)

E-mail address:*

Research Institution:*

Graduating Department:*

Program:*

CPIN 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:*

Lecture Title:*

***You must list and respond to both keynote lectures from CPIN Research Day for full credit.

Please be concise; limit answers to 1-2 brief points.

1. The main focus of the lecture:*

***You must list and respond to both keynote lectures from CPIN Research Day for full credit.

2. List the most important information that you have learned from this lecture:*

***You must list and respond to both keynote lectures from CPIN Research Day for full credit.

3. List one question that you have asked or would like to ask the speaker:*

***You must list and respond to both keynote lectures from CPIN Research Day for full credit.

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*

I certify that I have personally attended this lecture & completed this form which will be kept as a record in the CPIN office

Would you like to be contacted regarding:

meeting with upcoming lecture speakers

upcoming CPIN volunteer opportunities