University of Northern Iowa
Department of Psychology
Cedar Falls, IA 50614-0505
MASTERS PROGRAM IN PSYCHOLOGY
Application Deadlines: Admission--April 3, Financial Aid--February 1---EARLY APPLICATION IS STRONGLY ENCOURAGED.
Admission begins on a rolling basis after the February 1 deadline.
1. Name _____________________________________________________________________________________
Last
First
Middle
Present address: _______________________________________________________________________
Permanent address: ____________________________________________________________________
Cell phone: ____________________________ Alternate phone: __________________________
E-mail address: ________________________________________________________
Birth place:
___________
Birth date:
Citizenship: __________________
2. Previous Academic Training (post-high school):
Institution
Dates Attended
Major
Degree
Date Conferred
3. GRE Scores:
Verbal
Quantitative
Analytical/Writing
Advanced
4. Previous Research Activity:
5. Relevant Work Experience:
Organization
Dates
Responsibilities
Date Taken
______
GPA
6. Relevant Extracurricular Activities:
7. Psychology-Related Public Service:
Organization
Dates
Responsibilities
8. Awards, Distinctions, Honors:
9. Presentations or Publications:
10. Area of interest (circle or bold one):
Clinical Science
Social
Individualized Study
On a separate page, discuss your interests in psychology and your educational and career goals.
11. References: List the names and professional titles of three people who are familiar with your qualifications for graduate study.
Please include former instructors and those engaged in or familiar with the field of psychology. Request that references submit their
letters directly to the Department of Psychology.
Name
Title
Institution
Applicants must file a transcript from all colleges or universities attended (if other than the University of Northern Iowa). Applicants
should have GRE scores and transcripts sent directly to the Registrar’s Office at UNI.
“The University of Northern Iowa requests this information for the purpose of considering you for admission to the Masters
Program in Psychology. No persons outside the University are routinely provided this information, except for items of
directory information such as name and local address. Release of any information is governed by Board of Regents rules and
applicable state and federal statutes. If you fail to provide the required information, the University may not consider your
application.”
Please sign indicating you have read this statement.
_____________________________________________________
Name
Date