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BSW Field Education Manual - School of Social Work at the ...

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36<br />

Appendix B<br />

<strong>BSW</strong> <strong>Field</strong> <strong>Educ<strong>at</strong>ion</strong> Applic<strong>at</strong>ion<br />

Demographics<br />

D<strong>at</strong>e _____________________________________________________________<br />

Name _____________________________________________________________<br />

Email _____________________________________________________________<br />

Telephone ________________________________________________________<br />

Mailing Address ___________________________________________________<br />

___________________________________________________<br />

Eligibilities<br />

Is your overall GPA a 2.5 or higher<br />

▫Yes ▫No<br />

Have you or will you have completed all pre-pr<strong>of</strong>essional courses (including<br />

foreign languages) prior to <strong>the</strong> beginning <strong>of</strong> fall semester<br />

▫Yes ▫No<br />

Have you made applic<strong>at</strong>ion to <strong>the</strong> pr<strong>of</strong>essional <strong>BSW</strong> curriculum and program<br />

▫Yes ▫No<br />

Are you able and willing to abide by <strong>the</strong> NASW Code <strong>of</strong> Ethics ▫Yes ▫No<br />

O<strong>the</strong>r<br />

Do you have a car<br />

Are you applying to <strong>the</strong> Public Child Welfare Title IV-E Program<br />

Do you fluently speak a language o<strong>the</strong>r than English<br />

Wh<strong>at</strong> language<br />

▫Yes ▫No<br />

▫Yes ▫No<br />

▫Yes ▫No

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