Student Services only
SLN:
EC:
Email Student: _______________
PHD IN SOCIAL WELFARE
Student Name:
Social Welfare 515: Service Practicum Registration Form
To obtain a registration entry code, this form must be completed in full
and routed through email approval by all parties
AT LEAST 2 WEEKS PRIOR TO FIRST DAY OF THE QUARTER
Routing Process:
Student: Save template form to personal computer and name file “lastname-course#-quarter. Forward file via email to
course instructor.
Instructor: Enter your name on the Instructor line and check the box indicating instructor approval. Then email this file to
the Program Office (kwilham@uw.edu).
Student and Faculty member should fill out the form together if possible. However, the email to the Program Office must
come from the faculty instructor.
Program Office: Prints out form, obtains Program Director Approval; then emails entry codes to the student.
This document serves as the course syllabus and contract. [Use input fields; document length not to exceed 2 pages.]
SocWL 515
Quarter:
Year: 20
Community partner organization(s):
Practicum Contract: (See PhD Online Program Manual for Instructions.)
Project description and primary objective: Include a brief description of the proposed practicum. project and estimated
time student will devote to the project.
Learning Goals: Goals should in general link to the Guidelines for Research Competencies appropriate for communitybased research, and at least one goal must be derived from the Social Justice Learning Objectives matrix.
Learning Goa1 1 (include training activities to be undertaken and format for evaluation):
Learning Goa1 2 (include training activities to be undertaken and format for evaluation):
Learning Goa1 3 (include training activities to be undertaken and format for evaluation):
Additional (include training activities to be undertaken and format for evaluation):
Instructional Meeting Schedule:
Brief Description of Proposed Written Product:
The final written product is submitted to the Director by the 10th week of the practicum quarter.
STUDENT NAME:
INSTRUCTOR'S NAME:
PhD DIRECTOR SIGNATURE:
(http://depts.washington.edu/sswweb/programs/phd/phdforms/phd-515reg-form.doc; Oct 2012
Emailed to instructor
Email approval
PhD in Social Welfare
STEP-BY-STEP PROCEDURES FOR THE
SERVICE PRACTICUM
COURSE FORMAT: One or two quarters, 3 credits per quarter, can be taken at any time, Credit/No Credit only
The primary goal of the service practicum is to provide doctoral students with service experience that advances their
preparation for working in partnership with community institutions as a scholar. Most doctoral students will come to
their studies with good experience working in community settings, in the roles of clinician, service provider, or organizer.
The service practicum offers an opportunity to work in similar settings, but in the role of research or scholarly
collaborator. Students undertaking a service practicum will develop specific skills for working as a scholar in community
settings through ongoing reflection and consultation with a faculty mentor. Students’ practica will vary in content and
expectations, making it essential for students to work closely with a faculty member to select and design a service
practicum experience that contributes to their learning and development and does not replicate professional experience.
The project and contact with the community partner will typically be initiated by the student and faculty mentor, and
design of the service practicum project will be collaborative, involving the student and the community partner, in
consultation with the faculty mentor.
Practicum Objectives
The primary objective of the practicum is to strengthen students’ ability to bring their emerging scholarly skills and
vision to their work with community partners. Service practica will be established in situations in which the students’
presence is of service to community partners and advances the students’ development as scholars, researchers, and
academics. Students will have faculty guidance in making the transition from the perspective of direct service provider to
the perspective of scholarly collaborator and explore ways in which they can be of service to the community, the field,
and their academic institution.
The following aspects of service activities are important for all students and thus reflect common objectives for all
practica:
1. Understanding one’s role in collaborating with the community partners, and breadth and limitations of one’s role
as a scholar in community collaborations.
2. Learning to build and maintain constructive relationships with communities in the student’s area of interest to
bridge the gap between research and practice.
3. Practicing bringing one’s scholarly understanding of disparities and injustices to such collaborations.
4. Learning how to balance community goals and one’s own scholarly objectives, and how to work together with
mutual respect and transparency.
5. Exploring the tensions and synergies of academic/community collaborations.
6. Engaging in just partnerships and reflecting on the impact of identity, power, and the privilege of the academy in
service work.
(http://depts.washington.edu/sswweb/programs/phd/phdforms/phd-515reg-form.doc; Oct 2012
REGISTRATION PROCEDURES/CONTRACT
1. Student and preceptor meet to develop the service practicum learning contract and complete this registration form,
which serves as the contract.
a. The contract should include the following.

Days and hours the student will regularly devote to the practicum.

Research skills the student will learn.

Research tasks the student will perform.

Research training the faculty preceptor will provide.

Time and frequency of supervisory meetings between the student and preceptor.

A brief description of the written product that will issue from the practicum.
b. The required authorizations must be obtained.

Student: Save template form to personal computer and name file “lastname-SocWL515-quarter-year.
Meet with course instructor to complete form, then forward file via email to instructor.

Instructor: Enter your name on the Instructor line and check the box indicating instructor approval. Then
email this file to the Program Office noting in the email what student and course this form is for. Student
and Faculty member should fill out the form together if possible. However, the email to the Program Office
must come from the faculty instructor.

Program Office: Prints out form, obtains Program Director Approval; then emails the student with entry
codes.
Practicum Evaluation
At the end of the practicum, the student and mentor should meet together to evaluate the practicum experience. The
student fills out an evaluation of the practicum and submits it to the Program Director.
(http://depts.washington.edu/sswweb/programs/phd/phdforms/phd-515reg-form.doc; Oct 2012