Research Assistant Application for Dr. Winter’s C.H.A.M.P. Lab

Name: ______Date: ______

E-mail Address: ______Phone: ______

Major(s): ______Minor(s): ______

Year at VCU: ______Expected graduation month and year: ______

Overall GPA: ______Psychology GPA: ______

Have you ever been convicted of a felony or sexual assault charge: ___ YES ___ NO

Please indicate if you have taken any of the following courses:

Relevant Courses / When taken? / Grade
PSYC 214 Application of Statistics
PSYC 301 Child Psychology
PSYC 302 Psychology of Adolescence
PSYC 304 Life Span Development
PSYC 317 Experimental Methods
PSYC 426 Child Psychopathology
PSYC 494/493/492 (describe below)

List two references, preferably at VCU, who can speak to your suitability for this position. Please, no family members or friends.

1) Name: ______
E-mail address and/or phone number: ______
How s/he knows you (e.g., professor, boss, etc.): ______

2)Name: ______
E-mail address and/or phone number: ______
How s/he knows you (e.g., professor, boss, etc.): ______

Please indicate if you have a preference for working on a particular project.
(See our website or flyer for descriptions of current projects: champlab.vcu.edu)

______

What are your goals for being a research assistant? Why are you interested in becoming involved with research?

______

Do you have any previous research experience? If so, please describe.

______

Do you have any experience working with children or parents? If so, please describe.

______

What are your plans after graduation?
______
______

Have questions?
See champlab.vcu.edu or contact .

Please provide your schedule so that we can get a sense of your availability.
If you don’t know for sure yet, that’s okay; just provide your best educated guess.

Please put an “X” in the boxes for all of the times you are notavailable.

Monday / Tuesday / Wednesday / Thursday / Friday / Saturday
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
8:00 PM

Please note that these are not times you will definitely be scheduled in the lab; we are looking at availability.