The University of Mississippi

Application for Admission to Graduate Study in Psychology

Date  _______________________________________	SS#  _______________________________
Name (last, first, middle): ________________________________________	Day Phone  _______________________________
Present Address: ________________________________________	Evening Phone  _________________________________
________________________________________	E-mail ___________________________________
________________________________________

 

 

(Is e-mail an effective means by which to contact you? Yes____ No ____ )

If we need to contact you after April 15, is the contact information you provided above valid?

If not, please provide alternative contact information, along with the effective start date.

Date of change _______________________________	Day Phone _______________________________
Address ___________________________________________	Evening Phone _______________________________
___________________________________________	E-mail ______________________________
___________________________________________

Application for Ph.D. Program  

in ___ Clinical Psychology

or ___ Experimental Psychology ( ___Behavioral Neuroscience, ___Cognitive Psychology, or ___ Social Psychology)

 

Academic History (Include all institutions attended.)
Institutions From Which You Received A Degree
College/University	Major	Degree Received	Date of Degree	Overall GPA	Jr. & Sr. GPA

Other Institutions Attended
College/University	Major	Dates Attended	GPA

 

Graduate Record Examination (List all administrations.)
Date	Verbal	Quantitative	Analytical	Psychology

Comments (regarding academic history and/or graduate record examination):

_________________________________________________________________________________________

 

_________________________________________________________________________________________

 

Honors (Honor Societies, Scholarships, Fellowships, etc.):

_________________________________________________________________________________________

 

_________________________________________________________________________________________

 

References (List the names of at least three professional persons who are familiar with your academic and/or professional work, and whom you have asked to write us regarding your qualifications.):

_________________________________________________________________________________________

 

_________________________________________________________________________________________

 

_________________________________________________________________________________________

 

_________________________________________________________________________________________

 

On a separate page, list every course, credit, and grade you have taken in the following areas:

A. Undergraduate (Psychology courses and Related courses [Mathematics, Science, Social Science])

B. Graduate (Psychology courses and Other Graduate courses)

 

Relevant Background and Professional Goals. In 500 words or less, summarize your experiences (academic, vocational, or personal) and skills (e.g., laboratory, treatment, computer programming) that will help us evaluate your qualifications for graduate training in psychology. Furthermore, in your narrative you should discuss the fit or compatibility between your goals and the type of graduate training offered here. Specifically, state your reasons for interest in the University of Mississippi as compared with other graduate programs and indicate with which faculty you would most be interested in working.

 

__________________________________________________________________

(signature and date)

 

Return this completed form and the additional statements to:

Departmental Admissions Committee

Department of Psychology

University of Mississippi

University, MS 38677

 

Department application form and reference reports should be directed to the Department of Psychology. Graduate application form, official transcripts, and GRE scores should be directed to the Graduate School. All materials must be received by January 15 for your application to be considered.