ࡱ> \^[ mbjbj 42ccm||<,J!?Hv*t  $P$'z vv !.  :5 , K8"a !0J!k .'' '  J!'| : University of Toledo Graduate Student Annual Review of Professional Activities (GARPA) Reporting Period: May 16, 20__ to May 15, 20__ Name: Year in Graduate Program: Year of Entry: Gender:  FORMCHECKBOX Male  FORMCHECKBOX Female Ethnicity (these are APA's categories):  FORMCHECKBOX African American Black  FORMCHECKBOX Asian Pacific Islander  FORMCHECKBOX Caucasian White  FORMCHECKBOX Latino Hispanic  FORMCHECKBOX Native American Alaskan Native  FORMCHECKBOX Multi-Ethnic  FORMCHECKBOX Other I am subject to the Americans with Disabilities Act:  FORMCHECKBOX Yes  FORMCHECKBOX No I am a Foreign National:  FORMCHECKBOX Yes  FORMCHECKBOX No Nature of financial support during AY 20__-20__ (e.g., TA and related class(es), grant support if more than one type, state the number of hours for each): Contact Information (include address and email): Please complete the following items for the reporting period May 16, 20__ to May 15, 20__: Please list all professional or research societies to which you belong: Please give citations (APA style) for all papers, posters, workshops, or other professional presentations at professional or research meetings on which you were author or co-author: Please give citations (APA style) for all accepted or published articles, chapters, or books on which you were author or co-author (specify: accepted or published): Please list any grant-supported research in which you were involved (indicate whether you received the grant or were supported by a grant from a faculty member): Please list all ongoing teaching activities (specify whether course taught, lectures or other formal or informal talks, teaching assistant work): Please list all supervised practicum training (on or off campus) (includes practicum and externships activities but not internship activities): For students who are not currently on internship or postdoc, please report all of your practicum training activities in the Practicum Hours Tables (see accompanying file). If you are going on internship this year (2011), also attach your AAPI Part 1. Did you apply for internship for the 2011-2012 year?  FORMCHECKBOX Yes  FORMCHECKBOX No If you answered Yes, did you get an internship placement for the 2011-2012 year?  FORMCHECKBOX Yes  FORMCHECKBOX No For students accepted into an internship program (that starts in 2011), please (a) attach your AAPI Part 1 to your GARPA and (b) answer the following: Name of internship site: Date internship starts: Completion date for your internship: Internship setting: N/A Is it a paid internship?  FORMCHECKBOX Yes  FORMCHECKBOX No Is it a member of APPIC?  FORMCHECKBOX Yes  FORMCHECKBOX No Is it APA accredited?  FORMCHECKBOX Yes  FORMCHECKBOX No Is it a full-time or part-time placement?  FORMCHECKBOX Full-time  FORMCHECKBOX Part-time Is it a funded or unfunded placement?  FORMCHECKBOX Funded  FORMCHECKBOX Unfunded For students currently on internship (who started in 2010), please provide the following information about your upcoming postdoctoral activities: Name or names of sites (if more than one site, please list the percent amount of time spent at each): Postdoctoral or Employment? N/A Setting N/A Activity N/A Choose the main activity you are engaged in. Please list all clinical program requirements completed during the reporting period. Requirement Date Committee Members' Names Passed Master's Thesis Proposal Passed Master's Thesis Defense Received Master's Degree Major Advisor: Passed Professional Development Case Presentation Passed Professional Development Project Passed Dissertation Proposal Passed Dissertation Defense Received Doctorate Major Advisor: Started Internship Completed Internship Started Postdoc or Post-Internship Employment Finished Postdoc or Post-Internship Employment Students who are not currently on internship or postdoc: Please list all talks and training workshops attended either within or outside of the department, including job talks. Students who are not currently on internship or postdoc. Please list all department and university service you carried out (committees served on, graduate student mentoring, interviewing of prospective faculty or grad students, etc.): All students: Please list and describe any other relevant achievements accomplished. Wsu  & ' ( A B P Q R k l z { | ۻͦۻ͑ۻ|ۻgۻRۻ)jh5CJOJQJU^JaJ)j\h5CJOJQJU^JaJ)jh5CJOJQJU^JaJ)jth5CJOJQJU^JaJ)jh5CJOJQJU^JaJ#jh5CJOJQJU^JaJh5CJOJQJ^JaJ h3h5CJOJQJ^JaJ&h3h55CJOJQJ\^JaJ W A k   x \ ] d7$8$H$^gd5d7$8$H$gd5$d7$8$H$a$gd5      N O ] ^ _ d e s t u ˺˺˺{˺f˺Q˺)jh5CJOJQJU^JaJ)jh5CJOJQJU^JaJ)jh5CJOJQJU^JaJ)j,h5CJOJQJU^JaJ)jh5CJOJQJU^JaJ h3h5CJOJQJ^JaJ#jh5CJOJQJU^JaJ)jDh5CJOJQJU^JaJh5CJOJQJ^JaJ [ \  3 4 `  J ] p r 8:K˺˺򺑺k&h3h56CJOJQJ]^JaJ#h3h5>*CJOJQJ^JaJ&h3h55CJOJQJ\^JaJ)jvh5CJOJQJU^JaJ h3h5CJOJQJ^JaJ#jh5CJOJQJU^JaJ)jh5CJOJQJU^JaJh5CJOJQJ^JaJ* 4 5 6 89:;^_[\gd5d7$8$H$gd5d7$8$H$gd5 & Fd7$8$H$gd5KfB[` !"*+9ܴܢܢjܔUܢ)jh5CJOJQJU^JaJ)jbh5CJOJQJU^JaJ)jh5CJOJQJU^JaJh5CJOJQJ^JaJ#jh5CJOJQJU^JaJ&h3h55CJOJQJ\^JaJ&h3h56CJOJQJ]^JaJ h3h5CJOJQJ^JaJ#h3h5>*CJOJQJ^JaJ>? ./Gtu & Fd7$8$H$gd5gd5d7$8$H$^gd5d7$8$H$`gd59:;L-./Gbcqrsxyǵǧǧǧǧاا}ǧاhاS)j& h5CJOJQJU^JaJ)jh5CJOJQJU^JaJ)j:h5CJOJQJU^JaJ)jh5CJOJQJU^JaJh5CJOJQJ^JaJ#h3h5>*CJOJQJ^JaJ h3h5CJOJQJ^JaJ#jh5CJOJQJU^JaJ)jNh5CJOJQJU^JaJ @AOPQijxyzιΤΏze)jt h5CJOJQJU^JaJ)j h5CJOJQJU^JaJ)j h5CJOJQJU^JaJ)j h5CJOJQJU^JaJ)j h5CJOJQJU^JaJh5CJOJQJ^JaJ h3h5CJOJQJ^JaJ#jh5CJOJQJU^JaJRr$Sp{56x'()+bt&C^lmǵǵǡǵǡǍǡǵnǡǵcǍǵch3h5CJaJ h56CJOJQJ]^JaJh5CJOJQJ^JaJ&h3h55CJOJQJ\^JaJ&h3h56CJOJQJ]^JaJ#h3h5>*CJOJQJ^JaJ h3h5CJOJQJ^JaJ#jh5CJOJQJU^JaJ)j h5CJOJQJU^JaJ%AB 7iHwx()*+d7$8$H$gd5d7$8$H$gd5 & Fd7$8$H$gd5d7$8$H$^gd5+mgd5d7$8$H$gd5 & Fd7$8$H$gd521h:p5/ =!"#$% tDeCheck1tDeCheck2tDeCheck3tDeCheck4tDeCheck5tDeCheck6tDeCheck7tDeCheck8tDeCheck9vDeCheck10vDeCheck11vDeCheck12vDeCheck13vDeCheck14vDeCheck15vDeCheck16vDeCheck17vDeCheck18vDeCheck21vDeCheck19vDeCheck22vDeCheck20vDeCheck23vDeCheck24vDeCheck26vDeCheck25vDeCheck27u666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH66666666666666666666666666666666666666666666666666666666666666666p62&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@66 OJPJQJ_HmH nH sH tH J`J INormal dCJ_HaJmH sH tH DA D Default Paragraph FontRiR 0 Table Normal4 l4a (k ( 0No List @@@ ) List Paragraph ^m$PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVq1u`X=:tڣf{Xx {dV=|kPo۵(h[x )IеnW[@;0PDbRy( "IROnVxCD' bJZ65I[adH+^D )>s=h ۟~7zWo^=[Qr||[?|̦ o{O=4?}}L$Xx%@|Ư'11%i$P,c[GD7sH5. 4kIƉZKTPBM HN7|nB#L7^`!\29pCH3nMb#$.'19b%+vJ~.!DI;DPz l 2I ͚;|y3+~Dؕjw0e1vdǪzO^I57y+d8bnv 4?6CK\M#= ċ(0'1 zxpWc/_X4/A_[)^&(fp[_NiK7@wd5= I?>q샏ꚝΡ5Ӵ>3m=͡|7;:۱&?8ټ<}9H}]Ru Vx~p{3AsP~\v!cZ 6JOw׃SB HfЖ gpj*4nR2BM} rfw[BfV= vͅh7/sɳ ̲B3뤓eH=J_:hn$O\ʧFn;/x.M#+d,W87+IwOťwF) uepwPϬ pV$2v Sv(C8L\~+l`k& Y iTU#p~XHYHeʹ,fͰ-;Y7XmM 9ͬYMm*/稺W(r2bUGڱ]]HYUcF8U~ۍZZnJmi}kn^l m2 K9m  +m'AQk{N^dt ! * : b r x  @ P i y mG G G G G G G G G G G G G G G G G G G G G G G G G G G L# @0(  B S  ?Check1Check2Check3Check4Check5Check6Check7Check8Check9Check10Check11Check12Check13Check14Check15Check16Check17Check18Check21Check19Check22Check20Check23_GoBackCheck24Check26Check25Check27BlOe + c y   A j o (R|_u" ; s   Q z o  C I J [ o dlo3*{3PU(T&/ ^`OJQJo( 8^8`OJQJo(^`OJQJ^Jo(o  p^ `OJQJo(  @ ^ `OJQJo( x^x`OJQJo(H^H`OJQJ^Jo(o ^`OJQJo( ^`OJQJo(^`6o(.^`.pL^p`L.@ ^@ `.^`.L^`L.^`.^`.PL^P`L.3PUt        5mo@m@Unknown G.Cx Times New Roman5Symbol3. .Cx ArialoGoudyOldStyleT-BoldGoudy Old StyleuGoudyOldStyleT-RegularGoudy Old StylesGoudyOldStyleT-ItalicGoudy Old Style7.@Calibri?= .Cx Courier New;WingdingsA$BCambria Math"1h2IG2IG!24ee3HP)$Pw2! xx University of Toledojgahr2Matthew T Tull  Oh+'08 ( H T `lt|University of Toledojgahr2NormalMatthew T Tull2Microsoft Office Word@@K8@K8G7VT$m1 z m  !1.@Goudy Old Style--- )2 nT0 University of Toledo     2 n0    m2 A0 Graduate Student Annual Review of Professional Activities (GARPA)             2 y0   @Goudy Old Style--- 52 0 Reporting Period: May 16, 20   2 0 __  2 0   2  0 to May 15, 20 2 #0 __  2 30    2 `0 Name:    2 0    22 `0 Year in Graduate Program:      2 0    "2 `0 Year of Entry:    2 0    2 `0 Gender:    2 0  (  0  0 '----'--- 2 0 Male   2 0  *  0  0 '--1!--'--- 2 30 Female   2 a0    %2 `0 Ethnicity (these    ,2 0 are APA's categories):    2 M0     0  0 '-- --'--- %2 0 African American      2 0   2  0   2 $0 Black   2 G0     0  0 '----'--- 2 0 Asian    2 0   2 0   #2 0 Pacific Islander   2 70     0  0 '--1!--'--- 2 . 0 Caucasian    2 .0   2 .0   2 .0 White   2 .0     0  0 '--D4--'--- 2 A0 Latino    2 A0   2 A0   2 A0 Hispanic    2 A0     0  0 '--WG--'--- #2 T0 Native American     2 T0   2 T0    2 T0 Alaskan Native     2 T~0     0  0 '--k[--'--- 2 h0 Multi  2 h0 - 2 h0 Ethnic    2 h0     0  0 '--~n--'--- 2 {0 Other    2 {0    [2 `50 I am subject to the Americans with Disabilities Act:           2 0    0  0 '----'--- 2 0 Yes   2 0    0  0 '----'--- 2 0 No   2 0    12 `0 I am a Foreign National:       2 0  !  2  0  0  2 P0  0  2 0  0  0  0 '----'--- 2 0 Yes   2 0    0  0 '----'--- 2 0 No   2 0    J2 `*0 Nature of financial support during AY 20__       2 w0 - ,2 z0 20__ (e.g., TA and rel   82 0 ated class(es), grant support    2 0   2 0   2 0 if   _2 `80 more than one type, state the number of hours for each):           2 0     2 `0    S2 `00 Contact Information (include address and email):          2 0     2 `0     2 `0     2 (`0   ------------ M2 ;`,0 Please complete the following items for the       --- 42 ;|0 reporting period May 16, 20  2 ;.0 __  2 ;>0   2 ;B 0 to May 15, 20 2 ;0 __---  2 ;0 :  2 ;0   ---@"Arial------ 2 Nx0 1.---  2 N0  --- #2 N0 Please list all  2 N0 prof 82 N0 essional or research societies    2 N0   )2 N0 to which you belong:     2 N:0  @Goudy Old Style---- @ !O- ---  2 a0     2 t`0   --- 2 x0 2.---  2 0  --- J2 *0 Please give citations (APA style) for all     V2 20 papers, posters, workshops, or other professional     - @ !4- --- 2  0 presentations    2 0   ^2 70 at professional or research meetings on which you were          2 H 0 author or co   2 0 - 2 0 author   2 0 :  2 0  - @ !U-- @ !|H- ---  2 0     2 0   --- 2 x0 3.---  2 0  --- &2 0 Please give citati /2 0 ons (APA style) for all     V2 20 accepted or published articles, chapters, or books    2 0   2 0 on  - @ !5- ---@Goudy Old Style------------ "2 0 which you were    2  0 author or co   2 D0 - 2 G0 author   2 r0    2 v0 (--- 82 z0 specify: accepted or published--- 2 !0 ):  2 )0  - @ !|- ---  2 0     2 0     2 +0   --- 2 Ax0 4.---  2 A0  --- #2 A0 Please list any   2 A0 grant   2 A 0 - 2 A 0 supported  2 AO0   b2 AR:0 research in which you were involved (indicate whether you          - @ !dB- --- #2 T0 received the gra  ^2 T70 nt or were supported by a grant from a faculty member):        2 TV0     2 g0     2 }0     2 0   "System0F--  00//.. ՜.+,0 hp  University of Toledoe University of Toledo Title  !#$%&'()*+,-./012345789:;<=>?@ABCDEFGHIJKLMNOPQRTUVWXYZ]Root Entry FZ8_Data 1Table"'WordDocument42SummaryInformation(68DocumentSummaryInformation8SCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q