KSU Undergraduate Technician Option Program
Psychological Technician Option Program of Study

If you have any interest in the Psychological Technician Option, please fill in as much of this program of study as you can. This does not obligate you to take any courses or to continue in the psychological technician option. You can make changes in this program of study as you progress through the curriculum.

Please leave this program of study in the Psychology Department Office, Bluemont Hall, Room 492. If you have any questions concerning the Psychological Technician Option, consult with either Dr. Barnett or Dr. Frieman.

Name ____________________________
Local Address ____________________________
Local Phone No. __________________________

Class (check one)

Expected date of graduation______

For each of the following courses which you have completed, indicate the grade you received. For those courses you have not taken, but intend to, indicate the dates you plan to enroll in them.

  1. Courses in Major
  2. Psych. Courses in Psych. Tech. Option

  3. Other Psychology Courses

  4. Psych. Tech. Option Electives
    Courses in Education, Sociology, etc. (Note: Students completing this form for the first time may want to leave this section blank until they have a chance to talk with a Psych. Technician advisor.

Preferred period of field placement (spring, summer, fall) ____________
Preferred general location of field placement _______________________
Preferred type of field placement (hospital, community agency, institution for the retarded, etc. ______________________________________________________________________
List any experience you have had which you feel is relevant to a field placement.

  At the present time, how do you plan to use your training in the Psych. Tech. option?
  1. ______ As a career goal (employment as a Psych. Tech.)
  2. ______ As a help in admission to graduate study (clinical, experimental, etc.; please specify _______________________
  3. ______ As part of my general education.
  4. ______ As good experience for a career in another area (business, government, medicine, etc.; please specify ____________________________________________________
  5. ______ Other (please specify)
Other Comments: