SALISBURY UNIVERSITY SOCIAL WORK DEPARTMENT
FIELD PLAN
FOR INCOMPLETED FIELD INSTRUCTION
Student’s Name:
Student ID #
Student’s Program:
 BASW
 MSW Foundation
 MSW Concentration/Advanced Standing
Academic Year: __________
Title IV-E Student:
 Yes
 No
Agency/Location:
Field Supervisor:
Field Liaison:
This is an agreement between the student, the Field Liaison and the Social Work Field
Education Office. This agreement is being made due to the student not completing the
requirements for their field course, Field Instruction _____, SOWK _________
The requirement(s) not completed include:
________________________________________________________________________
________________________________________________________________________
Required coursework, grades and hours completed to date:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
The reason(s) the student was unable to complete them was:
________________________________________________________________________
________________________________________________________________________
The student is expected to complete the requirements by _________________________
The student is expected to maintain communication with _________________________
from the Field Office to keep the Field Office updated as to the student’s activities and
progress. The Salisbury University e-mail system will be the official means of
communication. Therefore, the student is expected to check their Salisbury University email a couple of times during the week.
This agreement ends on _________________________. If student fails to comply with
this plan, they will receive a failing grade for the course.
____________________________________
Signature of Student
________________________
Date
____________________________________
Signature of Field Liaison
________________________
Date
____________________________________
Signature of Field Office Representative
________________________
Date