Undergraduate Concentration in Clinical Psychology Program of Study If you have any interest in the Undergraduate Concentration in Clinical Psychology, please fill in as much of this program of study as you can. This does not obligate you to take any courses or to continue in the clinical concentration. You can make changes in this program of study as you progress through the curriculum. Please leave this program of study in the Psychology Department Office, Bluemont Hall, Room 492 after completing Basic Concepts in Clinical Psychology. Students must complete Basic Concepts in Clinical Psychology before enrolling in the Laboratory in Clinical Concepts. If you have any questions concerning the Undergraduate Concentration in Clinical Psychology, consult with either Dr. Barnett or Dr. Frieman. Name ____________________________ Local Address ____________________________ Local Phone No. __________________________ Class (check one) ___ Freshman ___ Sophomore ___ 1st Sem.Jr. ___ 2nd Sem.Jr. ___ 1st Sem.Sr. ___ 2nd Sem.Sr. Expected date of graduation______ For each of the following courses which you have completed, indicate the grade you received. For those courses you have not taken, but intend to, indicate the dates you plan to enroll in them. A. Courses in Major _____ General Psychology _____ Experimental Methods _____ Statistics _____ Cognitive Psychology _____ Princ. of Learning _____ Fund. of Percp. & Sens. _____ Psychobiology _____ Found. of Social Behv. _____ Psych. of Personality B. Psych. Courses in Undergraduate Concentration in Clinical Psychology Clinical _____ Psychological Testing _____ Abnormal Psychology _____ Basic Concepts in Clinical Psych. _____ Laboratory in Clinical Concepts _____ Field Placement C. Other Psychology Courses _____ ________________________________________ _____ ________________________________________ _____ ________________________________________ _____ ________________________________________ _____ ________________________________________ D. Undergraduate Concentration in Clinical Psychology Electives Courses in Education, Sociology, etc. (Note: Students completing this form for the first time may want to leave this section blank until they have a chance to talk with an Undergraduate Clinical Concentration advisor. o _____________________ o _____________________ o _____________________ o _____________________ Preferred period of field placement (spring, summer, fall) ____________ Preferred general location of field placement _______________________ Preferred type of field placement (hospital, community agency, institution for the retarded, etc. ______________________________________________________________________ List any experience you have had which you feel is relevant to a field placement. At the present time, how do you plan to use your training in the Undergraduate Clinical Concentration? 1. ______ As a career goal (employment as a Psych. Tech.) 2. ______ As a help in admission to graduate study (clinical, experimental, etc.; please specify _______________________ 3. ______ As part of my general education. 4. ______ As good experience for a career in another area (business, government, medicine, etc.; please specify) ____________________________________________________ 5. ______ Other (please specify) Other Comments: