If you are interested in participating in our research, you can register your family on this web site. When a study comes up that your child is the right age for, we will give you a call or send you an e-mail describing that particular study in detail. If you have interest and time to participate at that point, we will schedule an appointment.

Currently, we are looking for children between 0 and 10 years of age from Amherst and the surrounding areas. If you interested in bringing your child for a single visit lasting about 30 minutes, please fill in the form below and click on the “submit” button. We will acknowledge the receipt of the form by e-mail within a week, and your family will be added to our database!

All of your information is completely confidential; it is used only by researchers in developmental psychology at Amherst College to inform you about studies in which you may be interested in participating.

Thank you.

Contact Information

Parent One’s First Name: *

Parent One’s Last Name: *

Parent Two’s First Name:

Parent Two’s Last Name:

Street Address:

City/Town:

State:

Zip Code:

Preferred Contact Method: *

Phone

E-Mail

Either

Phone Number (including area code):

Phone Number Type:

Home

Work

Mobile

E-Mail Address:

How did you hear about us?

Word of mouth

Facebook

Visited our table at an event

Other:

Other Source

First Child

First Name: *

Last Name: *

Sex: *

Male

Female

Date of Birth: *

Month

Day

Year

Age (in years): *

Second Child

First Name:

Last Name:

Sex:

Male

Female

Date of Birth:

Month

Day

Year

Age (in years):

Third Child

First Name:

Last Name:

Sex:

Male

Female

Date of Birth:

Month

Day

Year

Age (in years):

Fourth Child

First Name:

Last Name:

Sex:

Male

Female

Date of Birth:

Month

Day

Year

Age (in years):

Language Exposure

Are your children regularly exposed to languages other than English? *

Yes

No

If yes, please list languages and amount of exposure:

Is there anything else you would like us to know?

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Amherst College
220 South Pleasant Street
Amherst, MA 01002

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