HDP 191 Pre-Enrollment Questionnaire

Please answer all of the following questions to the best of your ability.

Keep in mind that the information you provide will be used to determine your placement to a field research site.

Section I: Personal Information
Section II: Quarter Selection - Please indicate the quarter in which you:

Section III: Site Selection

Please review 2009-10 Field Research Site Opportunities

Answer the following questions to the best of your ability and list your top five (5) site choices. Please state your motivation behind choosing each site and remember that the reasoning you provide will assist the field research coordinator in placing you at a site that best fits your interests and future career aspirations.

Please note: You must select five (5) site choices in order to be considered for enrollment.

Please specify the age groups that you are most interested in working with:
Please specify the age
groups that you are most
interested in working with





Site Choice Please explain your decision
#1
#2
#3
#4
#5
Section IV: HDP 191 Orientation

You are required to attend one orientation meeting during the Spring 2009 quarter in order to complete your enrollment in HDP 191.

:

Section V: Your Records

Print out the following page for your records

The Human Development Program will send an e-mail confirming receipt of the Pre-Enrollment Questionnaire. If an e-mail confirmation is not received within 24 hours of submission, please call the HDP Office at (858) 534-9919 or e-mail Christina Knerr at cknerr@ucsd.edu.