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Practicum Application part 2

RAYMOND A. KENT
SCHOOL OF SOCIAL WORK
UNIVERSITY OF LOUISVILLE

 

 

Practicum Application

 

Official correspondence from the Practicum Office is sent to the street address and email address listed below. If the student moves and fails to update their contact information with the Practicum Office, the student will not be relieved of responsibility on the grounds that the communication was not delivered or not delivered in a timely manner.

This must be in the form ###-###-####
This must be in the form ###-###-####
This address will be used for all correspondence from the Practicum office, so make it the address where you can get mail in a timely fashion.
(Required)
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This must be in the form ###-###-####







Please place a checkmark in the box next to  ALL the programs that you have applied to; then select in the box below whether your application has been accepted or is pending:





































(Include social work experiences you wish to explore, skills you wish to acquire and career directions you are considering)
Please choose 3 and list in order of preference (1st, 2nd, 3rd): Aging/Gerontology, Alcohol/Drug/Substance Abuse, Child Welfare, Juvenile Justice, Developmental Disabilities, Family and Children's Services, Health and Hospital, Mental Health, School Social Services, Community Centers:
Please check the geographic area you prefer for your practicum assignment:










Alternative Practicum Arrangements:

(Please select the following if you are pursuing an on-job placement and do not want a practicum from the practicum agency roster pool. This option is available only if employed by the agency for a minimum of six months prior to the start of the practicum semester):

Please review the Policy for On-Job Practicum, follow carefully the step-by-step guidelines and submit all required documents within two (2) weeks. Please submit this practicum application form NOW and then follow up with the on-job proposal documents within two (2) weeks.




International Students

As an international student, I am aware that I must submit documentation from my faculty adviser within Kent School and from my practicum agency supervisor to inform the International Center at UofL that I am taking the practicum to satisfy the requirements for the MSSW degree, even though this is NOT a paid employment.  I acknowledge that I must do this for EACH semester that I am in practicum, preferably at the very start of the semester or before.  For more information, please see Curricular Practical Training Information.



Please note any other relevant issues, i.e., prior experience with specific agencies, alcohol/substance abuse or other addictive behaviors, pregnancy, impending marriage or divorce, planned surgery, physical or learning disabilities, special transportation needs, etc. Collaborating together on these issues now will help us plan to select the appropriate placement and build the support needed to promote your success in practicum. Please be aware that many practicum agencies require background checks and periodic drug screenings. Prior convictions for traffic and/or criminal offenses may perclude ones ability to be accepted in a practicum agency and/or licensed as a social worker in many states. Any negative findings that affect an agency placement may also prevent successful completion of the requirements for the degree. Applicants should consider these barriers in their educational planning.








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Please email current resume and photo (photo is optional) of yourself. This application is not complete without your current resume.

 

Martha A. Fuller, Director of Field Education
Kent School of Social Work, University of Louisville
Louisville, KY 40292
Phone: 502.852.3933 Fax: 502.852.0422
Email: martha.a.fuller@louisville.edu

By typing my initials in the box below, I grant permission to the Practicum Education Office of the Kent School of Social Work to release information from my Practicum Application for the purpose of arranging and maintaining my practicum placement. This release extends to several agencies when necessary for confirmation of a mutually agreeable placement.

(Required)
By typing my initials in the box below, I understand that making false statements and providing incomplete information may result in the cancellation of my Practicum Application. I certify that the information provided in this application is true and correct.

When you hit the "Send" button below, your application will be sent directly to the Director of Practicum. Martha Fuller will reply with a confirmation of receipt within 24 hours. If you do NOT receive a confirmation email within one day, you should call her at 502.852.3933 to verify receipt of your application. Once she also receives your resume, she will be back in touch with you to continue planning your practicum. You will then be mailed a letter with referrals and contact information to interview for your placement. After completing all the interviews, you will make your final selection and return a Placement Agreement form to Martha Fuller (included with the referral letter).

After hitting the "Send" button below, then send an email to martha.a.fuller@louisville.edu with your updated/current resume attached.


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