Child-Emotion Research Lab
Department of Psychology
University of Wisconsin at Madison
 
Undergraduate Student Application
 
 

Name:______________________________________                                      Date:_____________
 

Telephone:____________________            Email:______________________________
 

Major:_______________________            Overall GPA:________         Major GPA:__________
 

Semesters Completed:__________                       Expected Graduation Date:_______________
 

How many hours/research credits are you interested in?___________________________
 

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 one reference (another professor, previous employer, advisor) we may contact:
 

Name:__________________________________ Title:__________________________

Phone:________________ Email:________________________________________
 

Relation to you:________________________________________________________
 
 

Please list computer systems, programs, or languages with which you are familiar:
 
 
 
 
 
 

Please describe any previous experience you have working with children:
 
 
 
 
 
 

Briefly, what are your goals after graduation:
 
 
 
 

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

FALL SEMESTER Year:__________
Monday Tuesday Wednesday Thursday Friday Saturday
8am - noon
1pm - 5pm
evenings

SPRING SEMESTER Year:__________
Monday Tuesday Wednesday Thursday Friday Saturday
8am - noon
1pm - 5pm
evenings
 
 
 

This form may be printed and completed in handwritten form.
Place applications in the lab mailbox, located on the second floor of the Psychology Building.