PERMISSION SLIP
This interview will be conducted by the undersigned students, as part of the requirements in PSYCO1 (Introduction to Psychology) of AMA Computer College-Makati Campus, Makati City at National Center for Mental Health, Mandaluyong City.
The aims of this course are to introduce students to the basic concepts and principles of psychology and to encourage students to produce their own original write-ups about concepts relating to psychology by means of an interview.
Name of Students Signature: Student Number:
____________
____________
Signed:
MARLON B. RAQUEL
Instructor, PSYCO1
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__________________________________
(WORKING TITLE OF THE INTERVIEW)
Please sign below that you have read and agree with the following statements:
I understand that this interview is being conducted as part of the academic requirements for Introduction to Psychology, PSYCO1.
I confirm that the student has explained to me the working title of the article and the nature of its proposed content.
I understand that this material will be used only for classroom discussion.
Signed: _______________________________
Name of the Interviewee, Psychiatrist/Psychologist Date
(Signature over Printed Name)
Date:
______________________
