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* 1. Moderator Last Name

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* 2. Presentation Title (An abbreviated title is fine.)

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* 5. If "Other" category, enter type

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* 6. Please rate this lecture from 1 to 5 (1 = poor, 5 = excellent)

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* 7. Was the level of content appropriate?

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* 8. Would you ask this speaker to present again?

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* 9. Room Attendance Estimate

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* 10. Your Comments

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