Departmental application for admission to the Ph.D. program

Vita

Directions

Your vita should be produced on a typewriter or computer. Use the format below to organize your information under the bold face headings. Items must be listed in the following order:

BIOGRAPHICAL INFORMATION
Name
Social Security number
Current address/Permanent address
State of legal residence
Country of citizenship
Current phone/Phone where you can always be reached
E-mail address

EDUCATION
Institution, years attended, degree awarded
Major, area of concentration or emphasis, minor
Significant/Unique experiences (study abroad, internships, etc.)

HONORS AND AWARDS (fellowships, scholarships, service awards, etc.)

RESEARCH EXPERIENCE (paid or volunteer, e.g. research assistantships, fellowships, traineeships)
Institution(s), position(s), dates
Title or focus of research project
Brief description of your contributions (duties, responsibilities, level of participation)
Unique experiences
Supervisors

TEACHING EXPERIENCE (e.g. teaching assistantship, tutoring, etc.)
Institution(s), position(s), dates
Brief description of responsibilities

EXPERIENCES RELEVANT TO CLINICAL OR SCHOOL PSYCHOLOGY (joint program applicants only)
Institution(s), position(s), dates
Brief description of responsibilities

PROFESSIONAL EXPERIENCE (e.g., Campus projects - leadership positions; include experiences such as coordination, grant writing, planning, organizing, program creation or management)
Institution(s) position(s), dates
Brief description of responsibilities

PROFESSIONAL SOCIETIES (national, state or local)

PUBLISHED OR UNPUBLISHED MANUSCRIPTS (e.g. undergraduate thesis, manuscripts under review or in progress)
Author(s), date, title

CONFERENCE PRESENTATIONS
Conference name, date
Type and title of presentation

REFERENCES (List the three persons to whom you have given the enclosed recommendation forms.)
Name, title, phone, e-mail address

Revised September 2003