The University of Chicago School of Social Service Administration

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EDUCATION:Including Undergraduate, Graduate, and Professional SchoolsSSA Alumni: Yes:No:Area OfName of Institution Degree Year Earned ConcentrationLICENSES AND CERTIFICATIONS:Please check all that apply:LCSW: LSW: TYPE 73:LCPC: LFMT: CADC:Other: Please specify:
Personal Data FormSUMMARY OF SOCIAL WORK EXPERIENCE:Indicate Type of Work (Direct Practice, Supervisory, Administrative, etc.)Agency NameDatesOTHER WORK EXPERIENCE:PAST EXPERIENCE SUPERVISING STUDENTS:
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VII. Grading and Problem Solving fr
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Introduction to Field EducationPoli
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Field Education Staff and RolesNanc
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Field Readiness WorkshopsRequired f
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EEP at a GlanceEEP at a Glance2011-
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Education. Students will coordinate
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III. Responsibilities of Student in
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FIELD EDUCATION POLICIESDISCLOSURE
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7. Students in the School Social Wo
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THIRD QUARTER OF PLACEMENT• Revie
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Risk Management and SafetyIncidents
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IV. Responsibilities of Field Educa
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Field Instructor ChecklistField Con
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Selection and Evaluation of Field P
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V. Learning Contracts and Quarterly
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In the second year, clinical studen
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VI. Student Placement ProcessFirst
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Dual Degree StudentsDual Degree stu
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B. Assignment of a grade of FIn som
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Steps Toward Field Problem Resoluti
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Requesting a Field Placement Change
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THE SCHOOL OF SOCIAL SERVICEADMINIS
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STUDENT EVALUATION OF FIELD SEMINAR
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IX. Tool Box for Field Instructors
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Quick Reference: Full-Time/Part-Tim
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Field Placement Safety Discussion F
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Core Learning ContractDate:Student:
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3. Apply critical thinking to infor
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7. Apply knowledge of human behavio
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10. Engage, assess, intervene, and
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Clinical Learning ContractDate:Stud
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10. Engage, assess, intervene, and
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Social Administration Learning Cont
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Page 87 and 88: 10. Engage, assess, intervene, and
Page 89 and 90: Reflection Logs (All Students)Refle
Page 91 and 92: MACRO PROJECTS (First Year Requirem
Page 93: Program Planning/DevelopmentMACRO P
Page 96: School of Social Service Administra
Page 99 and 100: SCHOOL OF SOCIAL SERVICE ADMINISTRA
Page 101 and 102: Core Quarterly EvaluationDate:Stude
Page 103 and 104: 3. Apply critical thinking to infor
Page 105 and 106: 8. Engage in policy practice to adv
Page 107: Evidence to Support Ratings and Sum
Page 110 and 111: 1. Identify as a professional socia
Page 112 and 113: 5. Advance human rights and social
Page 114 and 115: 9. Respond to contexts that shape p
Page 116 and 117: Evidence to Support Ratings and Sum
Page 118 and 119: 1. Identify as a professional socia
Page 120 and 121: 5. Advance human rights and social
Page 122 and 123: 9. Respond to contexts that shape p
Page 124 and 125: Evidence to Support Ratings and Sum
Page 127: BENEFITS AND TRAINING FOR FIELD INS
Page 130 and 131: Brief Description of the Agency, It
Page 133 and 134: DIRECT PRACTICEAgency:So that we ma
Page 135: COMBINED CLINICAL / SOCIAL ADMINIST
Page 141 and 142: Essential Tools for Field Instructi
Page 143 and 144: M E M O R A N D U MTO:FROM:Field In
Page 145 and 146: CONTINUING EDUCATION CREDITSFOR FIE
Page 163: DIRECT PRACTICEField Instructor's S
Page 166 and 167: Did I assist the student in thinkin
Page 168 and 169: 3. The Code is designed to help soc
Page 170 and 171: expertise.Social workers continuall
Page 172 and 173: standards of confidentiality apply.
Page 174 and 175: 1.13 Payment for Services(a) When s
Page 176 and 177: (c) Social workers are prohibited f
Page 178 and 179: 3.06 Client Transfer(a) When an ind
Page 180 and 181: (b) Social workers who speak on beh
Page 182: Social workers should facilitate in
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The University of Chicago School of Social Service Administration

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