Letter of Reference Request for Dr. Malott*
*you must indicate that you “waive your right” to access to the letter on rele...
Self-Mgmt
Pre-Practicum
BSAP/Super P
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Electronic LOR Request Form

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Electronic LOR Request Form

  1. 1. Letter of Reference Request for Dr. Malott* *you must indicate that you “waive your right” to access to the letter on relevant forms NAME (include maiden name): EMAIL: Minor / 2nd Major: # of math courses taken: # of writing courses taken: Overall GPA: PSY GPA: Minor/2nd Major GPA: Math GPA: Writing GPA: Phone: Total GRE Score: Quantitative GRE Score: Verbal GRE Score: Names & deadlines of the Schools/Scholarships/Fellowships/Jobs, etc. for which you are applying (attach an extra sheet, if necessary): Name Deadline Additional forms to complete? 1) 2) 3) 4) 5) Yes Yes Yes Yes Yes No No No No No  Yes Yes Yes Yes Yes No No No No No Area of interest (e.g., Autism, DD, I/O, OBM, etc.): ____________________________________________________________________  Electronic Letter? Research projects in which you've been involved: _____________________________________________________________________ _________________________________________________________________________________________________________  Honors you've received from the psychology department or university: _____________________________________________________ ________________________________________________________________________________________________________ Malott PSY Course Semester Year T.A. Name 3600/1000H SUMMER 2104 Grade ABCDEFGHIJKLMNOPQRSTUVWXYZ 1400 Super A 4600 3570 Regular 3570 Intermediate 3570 Advanced 3980: BRSS 4990: BRSS Grad/GRE Prep A Create a zipped folder with the following (including this form) and send to Jennifer.L.Mrljak@wmich.edu:  Photo of yourself  Copy of WMU transcript (may be unofficial)  Resume/curriculum vita (CV)  Personal statement  Any additional forms (if applicable) Include a file folder or envelope with the following:  Forms (if applicable), complete including your signature  Addressed envelopes for letters/forms (USE 2 STAMPS)  An optional, self-addressed, stamped postcard we’ll mail to you when your letters have been sent Label & turn in to:  Graduate mailbox “M” in Psych Dept. (Wood Hall, 3rd floor)  Mailbox “Jennifer Mrljak” or door box in BATS lab (Wood Hall, 2536)  Mail to: 7535 Timbercreek Ct. #4 Portage, MI 49024 **Please e-mail Jennifer.L.Mrljak@wmich.edu to notify that materials are complete and have been turned in. Please allow 4-6 weeks for completion!
  2. 2. Self-Mgmt Pre-Practicum BSAP/Super P

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