Form 1 CPFP NCI Summer Curriculum Daily Survey

NCI Summer Curriculum– Daily Assessment Form

OMB No.: 0925-0642

Expiration Date: 05/31/2020

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0642). Do not return the completed form to this address.

Lectures

Day

Time

Lecture Title

Speaker 1

Overall Impression (Please Circle Your Answer):	Lowest				Highest
Your Level of Interest in this Topic	1	2	3	4	5
Your Knowledge of the Topic Prior to the Lecture	1	2	3	4	5
Your Knowledge/Understanding of the Topic Following the Lecture	1	2	3	4	5
Comprehensiveness of Lecture Content	1	2	3	4	5
Lecturer’s Engagement with Audience	1	2	3	4	5
The Length of the Lecture Was Appropriate	1	2	3	4	5

Additional Comments:

Speaker 2

Overall Impression (Please Circle Your Answer):	Lowest				Highest
Your Level of Interest in this Topic	1	2	3	4	5
Your Knowledge of the Topic Prior to the Lecture	1	2	3	4	5
Your Knowledge/Understanding of the Topic Following the Lecture	1	2	3	4	5
Comprehensiveness of Lecture Content	1	2	3	4	5
Lecturer’s Engagement with Audience	1	2	3	4	5
The Length of the Lecture Was Appropriate	1	2	3	4	5

Additional Comments:

Speaker 3

Overall Impression (Please Circle Your Answer):	Lowest				Highest
Your Level of Interest in this Topic	1	2	3	4	5
Your Knowledge of the Topic Prior to the Lecture	1	2	3	4	5
Your Knowledge/Understanding of the Topic Following the Lecture	1	2	3	4	5
Comprehensiveness of Lecture Content	1	2	3	4	5
Lecturer’s Engagement with Audience	1	2	3	4	5
The Length of the Lecture Was Appropriate	1	2	3	4	5

Additional Comments: