Complete each question below and submit within four weeks of your return or prior to graduation, whichever comes sooner.
It is recommended that you start working on gathering this information while at the conference. The information you provide in this questionnaire will be used by the Tracks and Special Programs Department and the Department of Clinical Education to verify your participation in the conference, confirm the credit you receive, and determine possible future recommendation to other students.
Student's Full Name
Student's ID Number
Name of the Conference
Organization Sponsoring the Conference
Website for the conference
Was there an application process and registration fee associated with this conference?
What were your travel arrangements to and from the conference?
Describe the type of housing arrangements (i.e. apartment, hotel, private home, hospital, dorm, etc., or N/A)
Describe your food situation. Were meals provided? How many meals? If meals were not provided, how did you eat?
Did you have Internet access? Was it free?
What was your cost for this event, including everything?
How well do you think this conference was structured?
List the lecture topics that you attended?
What was the "take-away" for each? Elaborate on three of the topics:
In what ways will this conference experience impact your future practice?
Reflect on your own expectations prior to the conference. In what ways were your expectations confirmed? In what ways were your expectations disproved?
Reflect on the conference presentations. In what ways did the conference challenge your biases or values?
What did you like the most and the least about this conference?
How likely are you to attend this conference in the future?
Anything else you would like to share, or we should know about your experience? Good or bad?
Would you recommend this experience to another student? In addition to the information above, what else can you tell future students to help them be prepared?
Do we have permission to share your information and experiences with others?
Please upload a certificate, receipt, or other proof of attendance.