This Form May Be Printed and Completed in Handwritten Form

Child Emotion Research Laboratory Undergraduate Student Application

This form can be completed and sent via e-mail to Anna Bechner at [email protected] Please save it with your last name as the name of the file.

Include a copy of your Unofficial Student Record (USR). Please see the registrar’s website on how to obtain unofficial transcripts: http://registrar.wisc.edu/student_record.htm

Freshmen may provide a copy of a high school transcript.

Date: ______Student ID #: ______Name: ______Address: ______Telephone: ______E-mail: ______Major: ______Overall GPA: ______Major GPA: ______Semesters Completed:______Expected Graduation Date: ______How many hours/research credits are you interested in? ______If you are responding to a specific research posting for this lab, please list the name of the contact person: ______

Computer Background:

Please list the operating systems, software, or programming languages with which you are familiar:

Experience and Academic Interests

Please provide a brief description of your academic interests:

What kind of research are you most interest in? Briefly, what are your goals after graduation:

Please describe any previous experience you have working with children:

Do you have prior laboratory experience?: ______If so, which lab(s)?: ______

Have you completed any of the following courses? (Note honors courses with an "H"): Abnormal Psychology: ______Child Development: ______Experimental Psychology: ______Behavioral Neuroscience: ______

Please list the jobs (paid and volunteer) you have had: Job Title/Description Dates of Employment Employer/Contact person ______

References Please list two academic or work-related references (another professor, previous employer, advisor) we may contact:

Name: ______Title: ______Phone: ______Email: ______Relation to you: ______

Name: ______Title: ______Phone: ______Email: ______Relation to you: ______SCHEDULE

Please place an "X" after times when you know you cannot work in the lab:

PLEASE NOTE: * Children attend school during the day. Most of our work with children occurs between the hours of 3pm-7pm, and on weekends. All undergraduate assistants will be required to work some weekends.

*Weekly meetings for the Child Emotion Research Lab are held at the Waisman Center on Wednesdays from 9:30-11:00 during the Fall and Spring semesters. Weekly attendance is required for all undergraduate assistants. Please reserve this time in your schedule.

Semester: ______Year:______

Monday Tuesday Wednesday Thursday Friday Saturday Sunday 8:00 8:30 9:00 9:30 Required 10:00 Lab 10:30 Meeting 11:00 11:30 12:00 12:30 1:00 1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 7:30