Letter of Reference Request for Dr. Malott**you must indicate that you “waive your right” to access to the letter on relevant formsNAME (include maiden name): Overall GPA: Phone:EMAIL: PSY GPA: Total GRE Score:Minor / 2ndMajor: Minor/2ndMajor GPA: Quantitative GRE Score:# of math courses taken: Math GPA: Verbal GRE Score:# of writing courses taken: Writing GPA:Names & deadlines of the Schools/Scholarships/Fellowships/Jobs, etc. for which you are applying (attach an extra sheet, if necessary):Name Deadline Add’l forms to complete? Electronic Letter?1) Yes No Yes No2) Yes No Yes No3) Yes No Yes No4) Yes No Yes No5) Yes No Yes No Area of interest (e.g., Autism, DD, I/O, OBM, etc.)?________________________________________________________ Research projects in which youve been involved:________________________________________________________________________________________________________________________________________________________________ Honors youve received from the psychology department or university:____________________________________________________________________________________________________________________________________________Malott PSY Course Semester Year T.A. Name Grade3600/1000HSuper A A4600BSAP/Super P3570 Regular3570 Intermediate3570 Advanced3980: BRSS4990: BRSSGrad/GRE PrepSelf-MgmtPre-PracticumCreate a zipped folder with thefollowing and send toJennifer.L.Mrljak@wmich.edu: Photo of yourself Copy of WMU transcript (may beunofficial) Resume/curriculum vita (CV) Personal statement This form Any additional forms (ifapplicable)Include a file folder or envelope withthe following: Forms (if applicable), completeincluding your signature Addressed envelopes forletters/forms (USE 2 STAMPS) An optional, self-addressed,stamped postcard we’ll mail toyou when your letters have beensentTurn in to: Graduate mailbox “M” in PsychDept. (Wood Hall, 3rdfloor) Mailbox “Jennifer Mrljak” or doorbox in BATS lab (Wood Hall,room 2536) Mail to: 7535 Timbercreek Ct. #4Portage, MI 49024**Please e-mailJennifer.L.Mrljak@wmich.edu tonotify that materials are completeand have been turned in.Please allow 4-6 weeks forcompletion!