Thank You for Your Interest in Our Program

Fall, 2018

Dear Student:

Attached is the application for formal admission to the BSW Program and also the application for BSWField Practicum. You beganyour studies in social work by declaring your interest in a social work major and enrolling in pre-BSW degree classes (SW100 and SW250). Upon acceptance by the Admissions Committee and formal admission to the BSW Program, your social work major will officially transition from pre-BSW to a BSW degree.

In the senior year of the program, a student who meets all course requirements (SW100, SW250, SW325, SW326, SW352 and SW353), plus the other requirements forformal admission to the BSW Program, is allowed to enroll in thePre-BSW Practicum Workshop (SW425) and the two semesters ofField Practicum (SW354, SW355).

This application covers two parts of the BSW student’s professional development. Part I is application for formal admission to the BSW Program (see listing of requirements on page 2, Instructions and Important Information). Part II, Application for Field Practicum, will be used by our department’sPracticum Office for the field placement.

It is your responsibility to make sure that all application materials (cover letter, Part Iand Part II of the applicationform, and two copies of your resume) are enclosed in ONE envelope as a single packet. To review your application materials we must have all items, and they must be received by 5 p.m.Tuesday, October 16, 2018if you want to begin your BSW Practicum in the Fall Semester of 2019. If you have questions, please contact the Social Work office at (785) 670-1616 or at .

Thank you for your interest in our program.

Bassima Schbley, LMSW, PhD

BSW Program Director

1700 SW College Avenue • Benton Hall, Room 412 • Topeka, KS 66621

O: 785-670-1616 • F: 785-670-1027 •

BSW Application for (1) Formal Admission and (2) Field Practicum

Submit Your Application On or Before
October 16, 2018
to begin the BSW Practicum in the Fall Semester of 2019.

In addition to completing and submitting this application, please make sure that you

have declared yourmajor (“pre-major”) in Social Work; and

have met with your academic advisor to review your BSW course of study.

Before you deliver or mail your packet to us, make sure it is complete.

Checklist forAssembling What You Must Submit

□ Cover Letter: The purpose of the cover letter is to introduce yourself to the Department of Social Work Admissions Committee. Describe your interest in social work and your career goals.Please write clearly, using correct spelling and grammar.

□Part I (Application for Formal Admission to the BSW Program) and Part II (Application for Field Practicum): Complete each item of the applications by filling in the gray text fields as directed. Make sure you initial each Attestation item on page 9and sign/date the bottom of the page. Please place all completed pages of bothapplication forms in a large envelope along with the other required application documents (e.g., cover letter, two copies of your resume).

□Resumé:Submit two (2) copies of a carefully prepared 1-2 page resume(single-sided, no staples) summarizing pertinent educational, employment, volunteer, and community service experience. Begin with your present position, and include any paid employment with the military, VISTA, Peace Corps, etc. Include this with the other materials in the large envelope.

□Delivery of the Application: Hand-deliver (preferred)or mailyour completed application packet to: Attn: BSW Admissions, Washburn University Department of Social Work, Benton Hall, Room 412, 1700 SW College Avenue, Topeka, Kansas 66621.

PLEASE MAKE A COPY OF YOUR ENTIRE APPLICATION PACKET FOR YOUR FILE.

SUBMIT THE ORIGINAL COPY OF THE ENTIRE PACKET, INCLUDING THE

BSW PROGRAM ATTESTATION FORM, TO THE SOCIAL WORK DEPARTMENT.

Instructions and Important Information

It is our desire that this application process be a welcoming and user-friendly process for you. You can help by reading all the materials carefully, providing clear documentation, and by adhering to deadlines. We will be happy to answer any of your questions. You can reach us at (785) 670-1616 or .

Application Requirements

Refer to the BSW Student Handbookon the Social Work Department websiteif you would like a more detailed explanation of these requirements. Persons not meeting published admission requirements are encouraged to contact the department for more information. Basic requirements include:

1.Current enrollment as a student in good standing at Washburn University as defined in the current Washburn University Catalog.

2.Approved Declaration of Major (pre-major) in Social Work.

3.An overall (cumulative) grade point average of at least 2.5.

4.Completion of a minimum of 36 hours of General Education course credits.

5.Submission of a completed “BSW Applicationfor (1) Formal Admission and (2) Field Practicum.”

6.If requested by the department, completion of an admissions interview with the BSW Program Director, the Social Work department chair, or a social work faculty designee.

7.If the Admissions Committee has any concerns about your application, references may be required upon written request of the BSW Program Director.

8. Please note that the following social work courses must be successfully completed (grade of C or better) prior to beginning the BSW Practicum: SW100, SW250, SW325, SW326, SW352 and SW353.

Field Practicum

In order to plan for the Fall 2019–Spring2020 BSW Practicum placements, there are several steps in the process. The Application for Field Practicum must be submitted along with the Application for Formal Admission to the BSW Program.

When returning your application in person (preferred) or by mail, request a practicum placement interview. This can be done at the time you bring your application into the office, or by phone if you mail your application. You will be assigned a Field Coordinator (Mallory Keeffe) and offered an interview appointment time.

Please arrive on time for your interview, and be prepared to discuss your specific interests concerning the type and location of your prospective placement. Your Field Coordinator will be happy to help you consider your options, but please carefully reflect on alternatives you wish to pursue prior to the meeting.

Review the BSW Student Handbook(which can be found on our department website Degrees) prior to the interview with your Field Coordinator.

The instructor in your social work practice classes will provide the Practicum Director with input regarding your readiness for field practicum at the end of Fall and Spring semesters.

Field Practicum marks the start of your professional social work career in the community. Two consecutive semesters (Fall and Spring) of field experience in the same practicum placement are required. A practicum seminar class must be taken concurrently both semesters. You must pass both practicum and seminar the first semester to proceed to the second semester.

Practicum begins during the first week of each semester, although some placements have an orientation before the start of Fall semester. Time in placement averages approximately 16 hours per week. The following is required: 240 hours per semester and 480 hours overall. Hours cannot be carried over into the next semester, nor can a student complete the practicum early.

Application Timeline

We have one application cycle annually, with an application deadline in the month of October.

Failure to complete the application procedure in its entirety may significantly delay the processing of your application. It is your responsibility to follow up with the Social Work Department, in a timely manner, to make sure your application is complete. PRACTICUM PLACEMENT CANNOT BE GUARANTEEDIF THE APPLICATION DEADLINE IS MISSED. Any falsification or misrepresentation of information in the application may be cause for rejection of the application or dismissal from the program, if the applicant has been admitted to the program.

You will be notified by mail of the Admission Committee’s decision.

Part I

Application for Formal Admission to the BSW Program

Submit by October16, 2018

Instructions for completing form: First, SAVE this document on your computer before completing it. Type your information and answers into the gray shaded form fields and check boxes. Fields will expand as necessary. When all fields are complete, SAVE again, PRINT a paper copy (SINGLE-SIDED ONLY, NOT DOUBLE-SIDED! NO STAPLES, PLEASE.) and sign where indicated. Attach your Resume with a paper clipand submit all SINGLE-SIDED documents as your application packet. Keep a copy of your complete application packet for your records.

Date (mm/dd/yyyy): Washburn ID (WIN) #:

Name: Last: First: Middle:

Telephone # (Home): (Cell): (Work): Ext:

Current Mailing Address: City: State: Zip:

MyWashburn Email: @washburn.edu

Cumulative GPA for all college-level coursework (including Washburn University and any other colleges, universities, or community colleges that you may have attended):

I hereby certify that the answers and statements contained in this application are true to the best of my knowledge/belief. (Print this page, then sign and date it.)

Signature / Date

Part II

Application for Field Practicum (BSW)

Fall 2019 - Spring 2020
Submit by October 16, 2018 to begin Practicum in Fall 2019

Work Information
Concurrent employment while attending the BSW Program (check one):

I plan to work Full-Time Part-Time

Current Employment -- Hours per week: Name of Employer:
How many hours per week will you be employed during your two semesters of field placement?
If you are considering a practicum at your place of employment:

When did your employment begin? (mo/day/year)
What is your position title and area of responsibility?

I am not currently employed
I will not be employed while attending the BSW Program at Washburn University.

STUDENTS MAY NOT SEEK THEIR OWN FIELD PLACEMENT.

DO NOT CONTACT ANY AGENCY BEFORE YOUR PRACTICUM OFFICE INTERVIEW.

Indicate below which fields of practice interest you. Choose 3 areas, ranking them in order of preference with 1 = highest and 3 = lowest. It is important to understand that (a) practice areas may have a limited number of available openings, (b) evening/weekend practica and stipends are rare, and (c) you must inform the Practicum Office of prior/current relationships with agencies under consideration for practicum placement or other issues that may complicate placement.

FIELD OF PRACTICE / PREFERENCE
Adult Welfare

Aging/Gerontology

Child/Family Welfare
Community Social Work/Advocacy
Disabilities
Substance Misuse/Addiction
Other (Specify):

Describe your strengths and limitations as they pertain to social work practice.

Indicate special circumstances that may affect practicum placement. Be aware that many placements require background checks (including felonies or misdemeanors) or health screenings.

Washburn University Department of Social Work

Field Practicum Office

Student Self-Evaluation

Student's Level: BSW

NAME: DATE (mo/day/year):

Write a brief statement describing what you will bring to the field practicum experience in each of the following areas. Use only this form.

1.Communication skills (oral, written, and languages in addition to English)

2.Practice related skills (assessment, planning, intervention/advocacy, evaluation)

3.Working under supervision and independently

On which area(s) of skill development would you like to focus as you enter practicum?

What helps you learn in new situations?

What would you like a field practicum to offer you?

Student signature: ______

Submit TWO COPIES of a 1- to 2- page, typed resume on white paper, single-sided, no staples. Include information about your college education/degrees, awards or honors, work experience, relevant volunteer experience, and career goals. The information will be reviewed by Practicum Office staff as part of the placement process. The information on this page and the resume will be shared with your prospective Field Instructor prior to your interview at the assigned agency.

Background History*: Please answer either “Yes” or “No” to the following questions. If you answer “Yes,” please attach a written explanation for each “Yes” response.

1.Have you ever been convicted of a felony?Yes No

2. Have you ever been found guilty of or liable for fraud or deceit in connection with services rendered as a social work service provider by a civil or criminal court of law or board of a professional organization? Yes No

3.Have you ever knowingly aided or abetted a person, not a licensed social worker, in representing him/her as a licensed social worker? Yes No

4.Have you used any alcohol, narcotic, barbiturate other drug affecting the central nervous system, or other drug which may cause physical or psychological dependence, either to which you were addicted or upon which you were dependent within the last two (2) years? Yes No

5.Have you ever been diagnosed or treated for any physical, emotional or mental illness or disease, including addiction or alcohol dependency, which limited your ability to practice behavioral sciences with reasonable skill and safety within the past two (2) years? Yes No

6.Have you used controlled substances which were obtained illegally or which were not obtained pursuant to a valid prescription order or which were not taken following the direction of a licensed health care provider within the past two (2) years? Yes No

7.Have you ever been found to be in violation of a professional association’s code of ethics or of a state licensing board’s rule and regulations or statutes regarding professional conduct? Yes No

8.Have you ever paid a judgment or settlement in a negligence action that concerned your social work profession? Yes No

9.Have you ever resigned from a professional association or surrendered your license to a state licensure board while an ethical complaint was pending against you? Yes No

10.Have you ever identified yourself as a social worker in Kansas (excluding student work)?

Yes No

I attest that I have answered the above questions truthfully. I understand that failure to do so may result in termination of the placement process and notification of such action to the Department Chair. I understand that if any of the above information changes I will immediately notify the Practicum Office.

(Print this page, then sign and date it.)

Signature / Date

*Note: These questions are drawn from the Behavioral Sciences Regulatory Board State of Kansas LBSW/LMSW application (pp. 2-3).

BSW Program Attestation Form

Please refer to theBSW Student Handbookto review each attestation item listed below. Once you have read the item section in the Handbook and understand it, please initial the box to the left of the item category. After you have read and initialed all the items noted in the handbook, please sign and date the bottom of this form and return it as part of your BSW application packet.

InitialItemPage #

BSW Mission(p. 5)

BSW Program Goals(p. 5)

New BSW Student Online Orientation(p. 9)

Registration/Enrollment(p. 13)

Academic Advising and Student Development(p. 13)

Academic Advising Guidelines for Social Work Students(p. 14)

Application for Graduation(p. 15)

Practicum and Seminar(pp. 15-23)

Practicum Hours(p. 23)

Additional Practicum Policies(p. 23)

Equal Opportunity Policy(p. 26)

Disability Services(p. 26)

Washburn Student Social Work Association(p. 26)

Academic Integrity and Honesty Policy(p. 27)

Courtesy Expectations(p. 27)

Confidentiality Policy(p. 27)

NASW Code of Ethics(p. 28)

Desire2Learn (D2L) Training(p. 28)

Required Subscription to Taskstream(p. 28)

Attendance and Class Participation(p. 29)

Communications and Official E-Mail Address(p. 29)

Writing and the APA Style (p. 29)

iCard(p. 30)

Instructor/Course Evaluations(p. 30)

Social Work Department Program Evaluations(p. 31)

Grading Policies(p. 32)

Academic Probation(p. 33)

Incomplete Grade(p. 33)

Course Withdrawal(p. 33)

Withdrawal from the Program(p. 33)

Grade Appeal Procedures(p. 34)

Academic Dismissal Procedures(p. 36)

Appeal of Academic Dismissal(p. 36)

I (the undersigned) have read and understand all the items listed above and agree to all stipulations contained therein. I acknowledge that failure to comply with these expectations may result in suspension in and/or dismissal from my academic program at Washburn University.

(Print this page after typing your name and WIN in the fields below, then sign and date it.)

Typed Name / WIN

______

Student SignatureDate