MUST BE COMPLETED AND RETURNED WITH APPLICATION
APPLICANT INFORMATION FORM
Department of Psychology
________________________________________________________________________________________________
In order for your application to be reviewed you must furnish a 300-word statement of purpose plus a statement of
research interests noting in question 1d if your interests match those of one or more of the faculty members (interests
are described in the brochure, "Graduate Study in Psychology"). These statements and this information form should be
returned directly in the Business Reply envelope to:
UNCG
Psychology Department
P. O. Box 26164
Greensboro, NC 27402-6164
The application materials required by the Graduate School (application form, fee, transcripts, GRE scores, and
recommendations) should be returned to the Graduate School in the envelope provided by December 15, 2003 for
applicants to the Clinical program and by January 15, 2004 for applicants to all other areas.
Name_________________________________________________________
Current
(Please Print)
Address_______________________________________________________
______________________________________________________________
Telephone Numbers_______________________________e-mail__________
1.
There are 4 areas of specialization in graduate training within the Psychology Department. Each student is
admitted to a particular area of specialization by the faculty members within that area.
a.
Rank these areas within psychology according to your interest in them (1= first choice, 2= second
choice). You will be evaluated in your first and second choice areas.
Clinical _______________
Developmental______________
Cognitive _______________
Social _____________________
b.
As stated above, your application materials will also be evaluated by the faculty in your choice area
of specialization. Rate below the extent of your interest in the second choice area.
?___________________?__________________?______________________?
Not Very
Somewhat
Seriously
As interested as
interested
interested
interested
my 1st choice area
c.
If you have other areas of interest within psychology, please indicate these (e.g. animal behavior,
neuroscience, behavior analysis, perception, etc.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
d.
2.
Which professors' research interests most closely match your own? (See brochure)
1.________________________________
3.____________________________________
2.________________________________
4.____________________________________
Regarding your undergraduate training:
a.
From what institution did you receive (are receiving) your bachelor's degree?
______________________________________________________________________________
b.
What was your undergraduate major?_________________________________________________
c.
What is your overall GPA?_________________________________________________________
d.
What is your GPA in psychology courses?_____________________________________________
MUST BE COMPLETED AND RETURNED WITH APPLICATION
Applicant Information Form
3.
List psychology courses you had as a undergraduate, or will have had by the time you graduate, and grade
obtained in each.
Course
Grade
Course
Grade
________________________
________________________
________________________
________________________
________________________
4.
____________
____________
____________
____________
____________
______________________
______________________
______________________
______________________
______________________
____________
____________
____________
____________
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Do you have a master's degree, or will you have one, by Fall of 2003? ___________
a.
if yes, from what institution?____________________________________
b.
If yes, what is the name of the Master's degree, and what was your area of specialization?
________________________________
c.
If yes, list the courses you took, or will have taken by graduation, and indicate the grade obtained in
each. (Please complete here even if you have included a transcript or attachment.)
Course
Grade
Course
Grade
________________________
________________________
________________________
________________________
________________________
5.
-2-
_____
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_____
_____
_____
___________________
___________________
___________________
___________________
___________________
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Other relevant information:
a.
Indicate the date on which you requested or will request that the Educational Testing Service send
your GRE scores to the Graduate School. _________________________
b.
If you have taken the Graduate Record Examination and know your scores, indicate them here. As
part of the application procedure, you must request that the official scores be sent to the Graduate
School by ETS, Princeton, NJ.
Verbal____________________(%)_________
Analytical_________________(%)_________
Quantitative________________(%)__________
Advanced__________________(%)__________
c.
List any paid or unpaid work or research experiences relevant to advanced training in psychology.
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
d.
Would assistantship funds be absolutely necessary in order for you to enter graduate
school?__________
Do you qualify for residency in North Carolina? (See Policies regarding residence status)_______
e.
f.
What would you see yourself doing in the field of psychology five years after you receive your
degree?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Revised February 1, 2001
____________________________________
Applicant's Signature
(Date)