Research Participation Form

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Complete this form if you would like to be contacted to participate in one of our research studies.

Self-Regulation, Education, & Aging Lab
Department of Psychoogy
Virginia Wesleyan University
Directed by Dr. Robert Ariel

Name *

Email Address *

Phone Number *

Age *

Sex

Male

Female

Intersex

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What is the highest education level you have completed?

Less than a high school diploma

High school degree or equivalent (e.g., GED)

Some college, no degree

Associate degree (e.g., AA, AS)

Bachelor's degree (e.g., BA, BS)

Master's degree (e.g., MA, MS, MEd)

Professional degree (e.g., MD, DDS, DVM)

Doctorate (e.g, PHd, EdD)

Clear selection

Are you a Virginia Wesleyan Student?

Yes

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If you are a VWU student or have obtained a college degree, what is your major?

If you are a current VWU student or enrolled in another undergraduate institution, what year are you?

Freshman

Sophomore

Junior

Senior

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How would you prefer to be contacted about participating in our research? *

Phone

No preference

Submit

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