Dr. Higa-McMillan Lab Department of Psychology University of Hawaii at Hilo PSY 399 or 499 Directed Research Application 1. Name: Date: 2. Phone Numbers: a.) Home b.) Cellular 3. E-mail Address: 4. Desired semester(s) of enrollment? and 5. What is your expected date (i.e., semester and year) of graduation? 6. Major: 7. Cumulative GPA: Psychology GPA: 8. Title of Project of Interest:____________________________________________________ 9. Please list all Psychology courses, along with your letter grades, that you have completed. If you are currently enrolled in any of the specific courses below, please write the initials ‘CE’ (currently enrolled) next to that specific course. If you have completed any of these courses at an institution other than UHH, please indicate that you have done so by writing that institution’s name in parenthesis after the course name. If applicable, Minor(s): Page 1 of 3 10. Please list any other courses, along with your letter grades, that you have completed that are applicable to the directed research experience and/or the research project for which you are applying. If you have completed any of these courses at an institution other than the UHH, please indicate that you have done so by writing that institution’s name in parenthesis after the course name. If you are currently enrolled in any of the courses please write initials ‘CE’ (currently enrolled) next to that specific course. 11. Describe any prior research experience you have. Include location and type of responsibilities you performed. 12. Please describe any computer experience you have. List computer software programs you are familiar with, especially any database (e.g., Excel, Access) or statistical programs (e.g., SPSS). Page 2 of 3 13. Please describe your short-term interests and how they are related to directed research with Dr. Higa-McMillan. Be sure to articulate your goals and how you think this course might help you reach them. 14. What are your long-term interests/career goals? 15. References: Please list the names of two current UH Hilo Psychology faculty members (excluding Dr. Higa-McMillan) that can serve as references regarding you rclassroom performance, interpersonal skills, peer-relations, and overall performance as relevant to being a member of a research team. a) Name:__________________________________________ Contact Information:______________________________ b) Name:__________________________________________ Contact Information:______________________________ Please email this completed application to Dr. Charmaine Higa-McMillan at higac@hawaii.edu. She will email you to set up an appointment for a brief interview. Page 3 of 3