Undergraduate Research Assistant Application
PSYC 485 Independent Study
Dr. Valentiner’s Anxiety Research Lab
Contact Information
Name
Street Address
City ST ZIP Code
Cell Phone
E-Mail Address
Availability
Please indicate, as specifically as possible, what times in your schedule you are available (mark with X).
Monday
Tuesday
Wednesday
Thursday
Mornings
Afternoons
Evenings
Background Information
Overall GPA
Psychology GPA
Anticipated date of graduation
Preference for number of PSYC
485 credits to take
1 (4 hrs/wk) or 2 (5-7 hrs/wk) or 3 (10 hrs/wk)
Class status
Sophomore or Junior or Senior or Super Senior
Do you plan on going to graduate
school? If yes, what do you
intend to study?
Yes or No
Clinical or School or I/O or Developmental or
Social or Cognitive or Other
Have you take Research
Methods?
Yes or No
Do you know how to use
PsycInfo?
Yes or No
Do you know how to use SPSS?
Yes or No
Favorite course and why
Least favorite course and why
Friday
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from courses, previous research
experience, volunteer work, or through other activities.
Psychology Interests
Summarize your interests in psychology.
References
Reference 1
Reference 2
Name
Relationship
Phone
E-Mail Address
Thank you for completing this application form and for your interest in
research.
Please return this application Dr. Valentiner’s office (PM 422) or to the Anxiety Research Lab (PM
334). Call (815) 753-7016 if you have questions or email Dr. Valentiner at dvalentiner@niu.edu.