SUMMER FULL TIME ADVANCED STANDING FIELD PRACTICUM PLANNING GUIDE I.

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SUMMER FULL TIME ADVANCED STANDING
FIELD PRACTICUM PLANNING GUIDE
I.
STUDENT INFORMATION
Date:
(Format: mm/dd/yyyy)
Name:
Local Information:
Address:
City:
State:
Daytime Phone:
Zip Code:
Evening Phone:
Email Address:
Summer Information (if different):
Address:
City:
State:
Daytime Phone:
Zip Code:
Evening Phone:
Email Address:
I am requesting a:
Concurrent placement for Fall/Spring (Concurrent placements are the standard field
arrangement for students at the School. Students must demonstrate a compelling reason
for the necessity of an exception.)
Ad Hoc or Block Placement (Review the policies on Ad Hoc and Block Placements in the
Field Education Manual; complete the appropriate Ad Hoc Placement Proposal or Block
Placement Proposal, and submit the request to the Director of Field Education.)
Placement in my employing agency (Review the policy on Placement in an Employing
Agency in the Field Education Manual, complete the appropriate Employer Based
Placement Proposal, and submit the request to the Director of Field Education.)
Concentration:
Direct Practice
Management and Community Practice
Self-Directed
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SUMMER FULL TIME ADVANCED STANDING
FIELD PRACTICUM PLANNING GUIDE
Experience:
Years of social work related employment experience:
full-time
part-time (approximate hours per week)
Years of other employment experience
Years of social work related volunteer experience
How frequently did you volunteer?
II.
PLACEMENT INTERESTS
A.
Briefly describe your BSW field placement (agency name, dates in placement, population served,
social work activities, significant learning).
B.
How did your BSW experience influence your social work interests?
C.
What do you imagine yourself doing, as a professional social worker, one year after graduation?
Five years after graduation?
D.
What client populations interest you the most? (For example older adults, children, adolescents,
individuals with mental illness, persons with disabilities, etc.)
E.
What social problems are most interesting to you? (For example poverty, child abuse, domestic
violence, homelessness, immigration, etc.)
F.
What supervisory style is the best fit with your approach to learning?
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SUMMER FULL TIME ADVANCED STANDING
FIELD PRACTICUM PLANNING GUIDE
Please check practice areas you would consider for your placement (check all that apply):
Children and their families
Child Welfare
Adults and their families
School Social Work
Family Violence
Substance Abuse
Mental Illness
Health Care
Aging
III.
SPECIAL CONSIDERATIONS
Language Skills:
Do you speak another language other than English?
Yes
No
If yes, please specify which language(s) and indicate proficiency below:___________________________
fluent (equivalent to a native speaker)
proficient (able to use the language accurately on a professional level)
conversant (able to participate in practical, social, informal conversations and limited professional topics)
limited (can satisfy minimum routine requests and courtesies)
Conditions of Scholarship or Stipend:
If you receive a stipend or scholarship, are there any conditions that may restrict your placement? If yes,
please explain:
Additional Considerations:
The Field Education Program makes every effort to match individual student needs with placement
learning opportunities. If there are other factors that we should consider as we plan your concentration
placement assignment (e.g. religion, culture, sexual orientation, gender expression, health concerns,
learning needs, other special needs), please explain below. If there is additional information which you
prefer to remain confidential, please contact the Field Education Office to discuss your situation.
Students with documented disabilities are asked to contact the University Department of Disabilities
Services to receive support and assistance with any accommodations necessary to enhance their
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SUMMER FULL TIME ADVANCED STANDING
FIELD PRACTICUM PLANNING GUIDE
learning. The Field Education Office strongly encourages students to be open with their Field Advisor and
potential Field Instructor in terms of special circumstances as this will assist in the selection of your field
placement site and the development of learning activities that best meet your individual needs.
UNIVERSITY POLICY ON NONDISCRIMINATION
The University is committed to providing an inclusive and welcoming environment for all
members of our community and to ensuring that educational and employment decisions are
based on individuals’ abilities and qualifications. Consistent with this principle and applicable
laws, it is therefore the University’s policy not to discriminate in offering access to its
educational programs and activities or with respect to employment terms and conditions on the
basis of age, gender, race, color, national origin, religion, creed, disability, veteran’s status, or
sexual orientation, gender identity or gender expression. Such a policy ensures that only
relevant factors are considered and that equitable and consistent standards of conduct and
performance are applied (see www.unc.edu/campus/policies/nondiscrim.html).
IV.
STUDENT PERMISSION
Does the field office have your permission to share all of the information in this Planning Guide and your
resumé with potential Field Instructors? If you have concerns about releasing this information please
discuss them with the Field Office.
Yes
No
Thank you for completing the Advanced Standing Planning Guide
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