Social Work Program Application Form

Application for Admission to the Social Work Program

Students applying for the Junior status in the Social Work program should complete this application during the sophomore year. Students needing assistance with completion of this application should contact a Social Work faculty member as soon as possible. See Application Procedures.

*Indicates Required Fields

Identifying Information

*First Name:
*Last Name:
Middle Name:
Local Address:	(CSS Box # or Other)
Local Telephone:
Permanent Address:	(If different from above.)
Permanent Telephone:	(If different from above.)
Email Address:
Current Advisor:	(If applicable)

College Information

Colleges Attended:	Degree/Certificates Received (or anticipated):	Dates Received:

Select or fill out as applies to you

Do you plan to attend school:
Which campus will you attend?
Anticipated Date of Graduation?
Overall Grade Point Average:

Grade Point Average in PSY/SOC/SWK courses:
Do you plan to attend graduate school in the future?
If yes, what field if other than social work?

Do you plan to be employed while you complete your degree?
If yes, approximately how many hours per week do you intend to work?

Background and Goals

Work and Volunteer Experiences: Describe your work and volunteer experience(s). Please give a more detailed description of any social work related experiences. Use an additional sheet of paper if necessary. Specify in distinction paid work and volunteer work.

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Professional Goals: Describe your short and long range professional career goals.
Strengths: Describe your personal strengths which you think will help develop into a good social worker.
Support and consideration: Briefly describe your any physical, emotional, learning challenges, or major responsibilities (e.g., employment, child care, elderly parents, ill family member, etc.) that may require extra support or consideration to help you succeed in the Social Work Department, short and long range professional career goals.
Personal History: Describe your background and the influences you believe have made an important contributions to your identity and to your choice of social work as a career.

References

Name:	Email Address:	Phone Number:	Title:	Relationship to applicant:

The Social Work Program reserves the right of accepting and retaining only those students who, in the judgement of the social work faculty, Admission Committee and Grievance Committee, satisfy the requirements of scholarship and the integrity of the social work profession as set forth in the NASW Code of Ethics.

In submitting this application, I am aware of the above admission criteria and requirement for the continued eligibility to be enrolled in the Social Work Program.

Signature:

Admin console

Main Campus

1200 Kenwood Avenue
Duluth, MN 55811
United States

800-447-5444

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