1. 1028700807085Yes, I give consentNo, I do not give consent00Yes, I give consentNo, I do not give consentChecking the box “yes” indicates that you give permission to the BACC system to use your information anonymously in professional presentations, publications, or honor’s theses. Checking the box “no” indicates that you do not give permission to the BACC system to use your Information anonymously in professional presentations, publications, undergraduate honor’s theses, graduate research and development project papers, or for the website, and we will not use it.Please select one of the boxes located below<br />Student Name:Interview Date:Meet With:Current Status:FreshmanSophomoreTotal Credits Earned: ___Current semester credits: Major:2nd major:Minor(s):Cumulative GPA:Raise?Psych GPA:Raise?<br />***Are in interested in Permission to Take Grad courses (PTG)?YesNoAre you interested in Dual Enrollment?YesNoHave you been a Teaching Assistant?YesTeacher:_________ Class: _______NoHave you been a Research Assistant?YesSupervisor: ___________________NoTopic: _______________________<br />List current and previous psychology classes:Grade:Semester:List Courses to retake:<br />Are you interested in applying to grad school?YesNoWhat orientation are you interested in (number 1st, 2nd, and 3rd choices)?____ Behavioral___ Non-behavioral___ EitherPlease indicate if you are interested in any of the psychology graduate programs at WMU:BA (Developmental disabilities and autism) - Frieder, Fuqua, PetersonBehavior Analysis (autism) MalottOrganizational Behavior Management/ Industrial - Dickinson, Huitema, McGeeClinical – Alessi, Damashek, Fuqua, Gaynor, Naugle, Spates, WrightExperimental Analysis - Baker, Pietras, Poling, Van Houten<br />Have you taken WMU’s GRE/ Grad School Prep course? YesNoInterested but haven’t taken itAnticipated Graduation date: _________Honor’s College?YesNoDean’s List? Semester/Year_____/_________/________/________/____Current Job:<br />Though all questions may not apply to you, please answer to the best of your ability<br />
