Global Practice Concentration Application Information contained in this application may be shared with representatives of the hosting organization. Name: Last Gender: Male q First Female q Current Address: No. Middle Initial Age:__________ Street City Date of Birth: ___________ State Zip Country Telephone: Home_______________________ Work Cell___________________ (Circle which number is best to reach you) E-Mail Address: ____________________________________________________________________ Please list all the languages you speak with a rating of how well you are able to communicate. This information will be taken in to consideration in determining your placement. There will be a verification process. Language: ____________ Speaking: Writing: ❏ Excellent ❏ Excellent ❏ Very Good ❏ Very Good ❏ Good ❏ Good ❏ Weak ❏ Weak Language: ____________ Speaking: Writing: ❏ Excellent ❏ Excellent ❏ Very Good ❏ Very Good ❏ Good ❏ Good ❏ Weak ❏ Weak Please Indicate: Clinical ❏ Macro ❏ Are you a citizen of the United States of America? Yes q No q If not, please specify country of origin: _____________________________________ Please provide the following information Name of Field Supervisor: _____________________________________ Name of current Advisor: _____________________________________ Please make certain the following are included in this application: I. Responses to the questions II. Two letters of reference from current Advisor and Field Supervisor (You may provide an additional professional reference in support of your application) III. Resume or CV q q q CORI CHECKS: Some countries may require a work permit or other long term visa requirements to work/live internationally. The work permit often includes a Criminal Offender Record Information (CORI) or a police clearance certificate from the last 7 places the student resided. Applicants with a criminal record should be aware that they may be precluded from the international field placement because they can not receive a work permit/visa. The School cannot guarantee an international field placement for students with a record of a criminal offense. Student Signature: ______________________________________ Date: ________ Page 1 of 2 Supporting Essay Questions 1. Write a statement about how participation in the Global Practice Concentration contributes to your current learning goals and how it fits with your long term career goals. 2. Based on your previous experience, what knowledge and skills would you be able to offer the hosting organization? 3. What professional knowledge and skills are you hoping to acquire from the Global Practice program? 4. Describe your experience in cross cultural settings or bicultural environments. (What countries have you lived/worked/volunteered in and for how long?) 5. What do you think will be the most challenging aspects of conducting a professional internship in a cross cultural setting? 6. Describe a challenge you may have encountered in a work/volunteer setting. Tell us how you managed the situation and where you turned for help. 7. Is there any setting or field of practice within which you feel you cannot work? If so, specify and indicate your reasons. 8. Have you spoken to your family, close friends and/or significant other about this program, specifically about the international field placement? How have they responded? 9. Please provide any further information which should be taken into consideration. Attach additional pages, as needed. Boston College School of Social Work Eileen Ihrig, Director of International Programs 126 McGuinn Hall 140 Commonwealth Avenue Chestnut Hill, MA 02467 Email: ihrig@bc.edu Phone: 617-552-1612 Page 2 of 2