Background Information
Up Background Information Beliefs about Cognitive Change

 

BACKGROUND QUESTIONNAIRE

Please complete the requested information and turn it in before leaving the first class. Bring a copy of your University photo ID to the next class meeting.

NAME:                                                 MAJOR:

E-MAIL:                                                     PHONE:

BACKGROUND OR EXPERIENCE IN PSYCHOLOGY:

 

 

BACKGROUND OR EXPERIENCE IN GERONTOLOGY:

 

 

 

BACKGROUND OR EXPERIENCE IN COGNITIVE PSYCHOLOGY:

 

 

 

PROFESSIONAL GOALS:

 

 

REASONS FOR TAKING COURSE; GOALS FOR COURSE:

 

 

 

 

AREAS OR QUESTIONS OF PARTICULAR INTEREST IN COURSE:

 

 

 

 

 

ANYTHING ELSE YOU WOULD LIKE THE INSTRUCTOR TO KNOW: