Louisiana State University
Department of Psychology Doctoral
Program Application Form
Fall 2016
Please type application
Applicant Name: ___________________________________________________________________________________
Present Address: ___________________________________________________________________________________
Phone: _______________________________ Email address: _____________________________________________
Have you ever gone by a name different than above? If so, what name: _______________________________________
Name and address of person through whom you can always be contacted: _____________________________________
Citizen of:
Specialization Area Intended/Professor you are most interested in working with
Please provide your full length answers to the following questions separately and attach to the application.
Education History (see page 2 to provide narrative)
Write a brief narrative (500-1000 words) describing your education experience, and list any awards or honors
you have received. Describe any psychological research you have done, including how many hours per week
and under whose supervision. List any publications or paper presentations you may have. If you are a clinical
psychology applicant, indicate what clinical experience you have had, including under whose supervision, how
many hours per week, and how many weeks.
Education Goals (see page 3 to provide statement)
Write a 500-1000 word statement giving your reasons for studying psychology and your professional goals.
Include a statement of how you hope to accomplish these goals by becoming a graduate student in our
department; be as specific as you can in relation to our program and particular faculty member(s), based on
your information about our graduate program and its faculty.
Application Deadline: December 1, 2015
Please upload this application along with supporting
materials to your Graduate School application.
Before submitting your department application, apply to the Graduate School and include this information
along with the essays listed above. It is not necessary to complete the statement of purpose on the Graduate
School application.
First choice (choose one):
Second choice (choose one):
