No. 1.] 



Name_ 



PSYCHOLOGICAL EXAMINING IN THE UNITED STATES ARMY. 



STANFCRD-B1NET EXAMINATION 



271 



_.. Age_ 



... Race- 



Company...— 



_. Regiment. 



.Arm- 



Where born 



Previous occupation 



Education: grade reached.. 

 Where educated 



Division___ Station-. 



,. Years in U. S. 



Weekly wages— 



High School. College 



_ Years in school _ , 



Disease history, personal and family.. 



Report 



Examiner „ _ Date 



Yr. 

 3... 



4... 

 5... 

 6... 



7... 



Credit 



Yr. Credit 



8 _ _... 



9 



10— --.- 



11„ 



12 _ 



Credit 



Yr. 



14 



16_ 



18 



M. Age 



Rating 



Credits 



Year III 



(6 TESTS, 2 MONTHS EACH, OR 4 'TESTS, 3 MONTHS EACH). 



•1. "Show me your": nose _ eyes mouth hair (3 of 4). 



*2. Names key penny closed knife watch peucil 



(3 of 5). 

 *3. Three objects in one picture: Dutch Home 



Canoe Post Office 



4. Gives sex. 

 *5. Gives last name. 

 Jo. Repeats (1 of 3): (a) I have a little dog; (6) The dog runs after 



the cat; (c) In summer the sun is hot. 

 Alt. Repeats (1 of 3): 641 352 .". 837 



Year IV 



(6 TESTS, 2 MONTHS EACH, OR 4 "TESTS, 3 MONTHS EACH). 



*1 . Compares lines (3 of 3, or 5 of 6) . 



2. Discriminates (7 of 10): Circle square triangle 



other errors _ 



*3. Counts 4 pennies (no error). 



*4. Copies square (pencil, 1 of 3): a..., o c 



*5. Comprehends (2 of 3). What must you do when you are 

 (o) sleepy. (6) cold. (c) hungry. 



6. Repeats (1 of 3): 4739 _ 2854..._..'. 7261 



Alt. Repeats (1 of 3 correct, or 2 with 1 error each): 



a. The boy's name is John. He is a very good boy. 



b. When the train passes you will hear the whistle blow. 



c. We are going to have a good time in the country. 



YearV 



(6 TESTS, 2 MONTHS EACH, OR 4 'TESTS, 3 MONTHS EACH). 



•1. Compares weights (2 of 3): 3—15 15—3 3—15 



2. Colors (no error): red yellow blue green 



*3. Aesthetic comparison (no error): oj b c 



♦4. Definitions (use or better, 4 of 6): 

 chair doll 



horse pencil 



fork . table 



*5. Patience (2 of 3, 1 minute each): a_ b c 



6. Three commissions. Key on chair brings box shots door_ 



Alt. "How old are you?" 



Division of Psye) 

 Authorized by the Surgeon 



, Medical Department, U. S. A. 



" , Feb. 8, 1918. Edition, August 7. 1918. 100.000 



Fig. 68.— Stanlord-Blnet Examination (first page). 



Printed by permission of 

 Hoogbtoa MifBJn Co. 



