Research Assistantship Application:

For The Social and Affective Neuroscience Laboratory & The Social Cognitive Neuroscience Laboratory

If you are interested in learning about research opportunities in Drs. Eisenberger and
Lieberman’s labs, please fill in the requested information. (Research assistantships may be
relevant to Psychology 194, SRP, or volunteer experience.)
1. Name ______________________________________________________________
2. Year in School:

________ Freshman ________ Sophmore ________ Junior ________ Senior

________ Transfer (please state where you transferred from and your year in school:
_____________________________________________________________________)

3. Cumulative GPA at UCLA ____________________

4. Contact Information
a) E-mail: _______________________
b) Best times to reach you at: _______________________
5a. Do you have any prior research experience? ___ Yes ___ No
5b. If you checked yes, please describe briefly the nature of your prior experience.
________________________________________________________________________
6a. Do you have any programming experience? _____Yes ______No
6b. If you checked yes, please describe briefly the nature of your prior experience and languages
you have experience with (including classes).
_______________________________________________________________________
7. What are you planning to do after you graduate from UCLA?
______________________________________________________________________________________

8. Please list course work completed that is most related to social neuroscience:
________________________________________________________________________
9. Below, please say a few words about why you are interested in this research position.

10a. Research assistants in the lab are typically asked to commit 8-9 hours a week is this
something you are able/interested in doing? If so, please indicate blocks of times during which
you could be easily and regularly available.
_____ Definitely ______________________________________________
_____Maybe (explain: ______________________________________________)
_____No
10b. Sometimes data collection opportunities will take place in the evenings and weekends.
Would you be willing to work during these hours?
_____ Definitely
_____Maybe (explain: ______________________________________________)
_____No
10c. Which quarter(s) would you be available to do research? Check all that apply.
____ Fall ____ Winter ____ Spring ____ Summer
10d. Ideally how many year(s) would you like to work in this lab? __________________
10e. Are you eligible for work study? _____ Yes, (if yes, #hours/week _____) _____ No
11. Please list any other extra curricular activities you participate in: ________________
________________________________________________________________________
12. Please list a couple of times this week that would work for you to come in for an
interview: ______________________________________________________________
_______________________________________________________________________
13. Thank you for taking the time to provide the requested information. We will try to contact
you as soon as we can. In case we cannot accommodate you at this time, would you like for us to
contact you about any future positions?
_____ Yes, please contact me as positions become available.
_____ No, I will not be available in future quarters.
Please return this form and your CV or resume electronically to michparr21@gmail.com