Supplemental Application for the Department of Psychology
Complete this form in addition to the Graduate Admission application and upload with your other application
materials by the December 15 application deadline. Applications are considered for the FALL semester start
date ONLY. EXCEPTION: BA Masters ONLINE program applications due October 31. BA Masters ONLINE
program start date is SPRING semester ONLY.
Name:
Email:
Phone:
1. OFFICIAL TRANSCRIPTS AND GRE SCORES REQUIRED AND MUST ARRIVE BY DEC. 15.
2. UNOFFICIAL (SELF-REPORT) GPA AND GRE SCORES. Reported GPAs will be verified by official transcripts.
Inaccurate self-reports will result in the elimination of an application from further consideration.
Unofficial GPA
Undergrad Institution Name:
Graduate Institution Name:
Overall GPA:
GPA:
Psychology GPA:
Undergrad Institution Name:
Graduate Institution Name:
Overall GPA:
GPA:
Psychology GPA:
Undergrad Institution Name:
Graduate Institution Name:
Overall GPA:
GPA:
Psychology GPA:
Undergrad Institution Name:
Graduate Institution Name:
Overall GPA:
GPA:
Psychology GPA:
Unofficial GRE
Date Taken:
Verbal + Quantitative Score:
Verbal Score:
Quantitative Score:
3. Which program are you applying for (check only one)?
BA Masters (on campus)
BA Masters (online)
BA Ph.D.
Clinical Ph.D.
IOBM Masters
Practicum
IOBM Ph.D.
Thesis
Either
4. FOR BA ONLY: The BA program is currently exploring options for developing a School Psychology Graduate
Program. If we are able to create this program, would you be interested in pursuing your graduate degree in
School Psychology (this may require a supplemental application and/or additional review process in
collaboration with the Special Education program)?
Yes
No
5. ADVISOR. List, in order of preference, the faculty member(s) whose research and practice interests best
match your interest. Please identify 2-4 faculty members. Do not leave blank. (See website for list).
1.
3.
2.
4.
1
6. What psychology or behavior analysis (BA) courses have you taken?
Course Name
Was this a BA course?
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Professor
Grade
6. FOR BA and IO ONLY: What behavior analysis books have you read?
Author
Title
7. Why are you interested in this program at WMU? (check all that apply)
The location of your current job
Its emphasis on contemporary
You have friends or family near by
behavior therapy/cognitive-behavioral
Its emphasis on behavior analysis
therapy
Its emphasis on
Program reputation
industrial/organizational psychology
Science-practitioner model
Its emphasis on evidence-based
Faculty member you wish to work with
practice
Other (please explain)
8. Career goals
For those applying to an MA program.
After graduating with an MA, you plan to:
work full time
pursue a Ph.D., then work as a consultant or
practitioner
pursue a Ph.D., then teach at a
college/university or pursue a research position
other (please specify)
For those applying to a Ph.D. program.
After graduating with an Ph.D, you plan to:
Work as a consultant or practitioner
Teach & research at a
college/university
Pursue a research position in an
academic setting/ medical school
Practice in a healthcare setting
Become a private clinical
practitioner
Work in program administration and
evaluation (e.g., in healthcare or
educational setting)
other (please specify)
2
9. Will you be able to attend school full-time?
Yes
No
10. History of criminal convictions*
I
have**,
have not ever been convicted of a criminal offense.
If I have, the conviction was:
* Applicants should understand that falsification of information is grounds for immediate dismissal of
your application and dismissal from any program into which you were admitted based on the
falsification of this item. Matriculation in some programs (i.e., clinical) requires students to submit to
formal background checks.
** Applications should understand that felony convictions do not preclude you from being considered
for graduate training but will likely limit opportunities for practicum and internship placement,
professional licensing, and future employment.
11. Statement of Rehabilitation
Applicants with criminal records must provide a written statement addressing consequent learning
and/or rehabilitation. Briefly describe your rehabilitation here. Use an additional sheet if necessary.
3