1. Yes, I give consentNo, I do not give consentChecking the box “yes” indicates that you give permission to the BACC system to use your information anonymously in professional presentations, publications, or honor’s theses. Checking the box “no” indicates that you do not give permission to the BACC system to use your Information anonymously in professional presentations, publications, undergraduate honor’s theses, graduate research and development project papers, or for the website, and we will not use it.Please select one of the boxes located below<br />Student Name:Interview Date:Meet With:Current Status:JuniorSeniorTotal Credits Earned: ___Current semester credits: Major:2nd major:Minor(s):Cumulative GPA:Raise?Psych GPA:Raise?<br />Are in interested in Permission to Take Grad courses (PTG)?YesNoAre you interested in Dual Enrollment?YesNoHave you been a Teaching Assistant?YesTeacher:_________ Class: _______NoHave you been a Research Assistant?YesSupervisor: ___________________NoTopic: _______________________<br />Have you completed a Practicum/Project?YesNoIf so, where? __________________PSY 1000 GeneralGrade: When:Honors? _______Super A? ______PSY 1400 Intro to Behavior AnalysisGrade:When:Honors? _______Super A? ______PSY 3570 WoodsEdge/KAC PracticumGrade:Semester(s):PSY 3600 Concepts BA:Grade:When:Super A? ________PSY 3980/4990 BRSS: Grade:When: PSY 4600 Survey BA Res:Grade:When:List Courses to retake:<br />Will you apply to grad school?YesNoWhat orientation are you interested in (number 1st, 2nd, and 3rd choices)?____ Behavioral___ Non-behavioral___ EitherPlease indicate if you are interested in any of the psychology graduate programs at WMU:BA (Developmental disabilities and autism) - Frieder, Fuqua, PetersonBehavior Analysis (autism) MalottOrganizational Behavior Management/ Industrial - Dickinson, Huitema, McGeeClinical – Alessi, Damashek, Fuqua, Gaynor, Naugle, Spates, WrightExperimental Analysis - Baker, Pietras, Poling, Van Houten<br />Have you taken WMU’s GRE/ Grad School Prep course? YesNoHave you taken the GRE?YesNoTotal Score:Verbal: ___ Quantitative: ___Anticipated Graduation date: _________Honor’s College?YesNoDean’s List? Semester/Year_____/_________/________/________/____Current Job:<br />Though all questions may not apply to you, please answer to the best of your ability<br />