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Marlene O'Neil Scholarship Application Form
This scholarship is presented in honor of Marlene O'Neil, retired Executive Director of the Michigan Psychological Association, for her 26-year stewardship of the MPA, and for her dedication to the advancement of the association and the profession of psychology.
PLEASE PRINT OR TYPE
Name (last, first, middle) ______________________________________________________
School Address (street, city, state, zip code): _______________________________________
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Home Address (street, city, state, zip code): _______________________________________
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Phone: __________________ E-mail: ____________________________________________
Name of university: ___________________________________________________________
Degrees Held (expected), Date (expected), institution and department where study will be conducted:
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Along with this completed form, please enclose:
Two letters of recommendation from Deans, Department Heads, Clinical Supervisors and/or Professors who have supervised your most recent academic or clinical work. These letters should present essential facts regarding:
a) scholastic record
b) character and personality
c) potential as researcher and/or clinician
d) ability to represent the highest standards of psychology
The head of the Department where you proposed to do your work must execute the following statement:
Name of applicant: _______________________________________________ is acceptable to this department for the standards connected with this scholarship.
Date: _____________________________________
Signature of Department Head: ________________________________________________
Name of Department: ________________________________________________________
I hereby certify that all information provided in this application is true and correct.
Date: _____________________________________
Applicant's Signature: ________________________________________________________
PLEASE PRINT OR TYPE
Statement outlining your career objectives:
List of awards, honors and scholarships/fellowships received:
Summary of teaching, research and clinical experience:
Tell us something interesting about yourself:
What led to your desire to become a psychologist?
What do you see as the most challenging issues confronting the profession?
Checklist:
- MPA 2008 membership
- Completed, signed application form
- Up-to-date academic transcripts
- At least two letters of recommendation
Timelines:
- Application submitted by September 1, 2008
- Successful applicant notified by September 21, 2008
- Award presentation at MPA Fall Convention October 19-20, 2008 (attendance not required)
Return completed application to:
Marlene O'Neil Scholarship Fund
Michigan Psychological Association
2105 University Park Dr., Ste. C-1
Okemos MI 48864
For questions:
Michigan Psychological Association
(517) 347-1885
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