Kerig Lab Research Assistant Application
Please complete this application and return it to Crosby Modrowski
(crosby.modrowski@utah.edu) & Michaela Mozley (michaela.mozley@utah.edu)
Name
Date (MM/DD/YYYY)
Phone number(s) (801-555-1212)
E-mail
Class
Freshman
Sophomore
Junior
Senior
Other
Major/Minor
GPA - Overall
GPA - Most recent semester
Number of hours per week you can assist
Would you be interested/able to assist for more than one semester?
Yes
No
Are you interested in assisting for course credit? You would commit to work 3 hrs/wk for each hour of
credit registered.
Yes
No
Are you hoping to write an independent project/honor's thesis/senior thesis related to this research
project?
Yes
No
Please check the times you could be available next semester. This is not a commitment and we realize
schedules change; it just makes it easier to match our needs with yours.
Monday
Tuesday
Wednesday
Thursday
8-10 AM
8-10 AM
8-10 AM
8-10 AM
10-12 PM
10-12 PM
10-12 PM
10-12 PM
12-3 PM
12-3 PM
12-3 PM
12-3 PM
3-5 PM
3-5 PM
3-5 PM
3-5 PM
5-8PM
5-8PM
5-8PM
5-8PM
Friday
Saturday
Sunday
8-10 AM
8-10 AM
8-10 AM
10-12 PM
10-12 PM
10-12 PM
12-3 PM
12-3 PM
12-3 PM
3-5 PM
3-5 PM
3-5 PM
5-8PM
5-8PM
5-8PM
Courses you have taken and grade received. Select 'Not Taken' if you haven't taken that course. If needed,
select 'Other' and use the blank field to elaborate.
Introduction to Psychology
Abnormal Psychology
Statistics
Abnormal Child Psychology
Research Methods
Please list any kinds of experience you have interacting with children/adolescents (e.g. swim coach for
local elementary school, Big Brother/Big Sister, summer camp counselor, etc.)
Please list any kinds of experience you have interacting with clinical populations (e.g. volunteer at a
rape crisis hotline, etc.)
Please list other research projects with which you have been involved. This can include research
projects in or outside of the Psychology department. Please include the professor and/or supervisor
you worked under as well as your responsibilities on the project.
Please indicate what, if any, experience you have working on a computer (include specific computer
applications that you are familiar with).
Please indicate why you are interested in being involved in this research project.
What are your future career plans?