The University of Hong Kong FORM A

Department of Social Work and Social Administration

Overseas/Mainland Fieldwork Placement 2017

Application Form

Student’s Particulars:

Name of Student: Program of Study:

Email: Mobile Phone No.:

Working/Volunteer Experience / Award Granted (if any):

Overseas Travelling/Residence Experience (if any), please also specify the duration:

Academic Performance(leave it blank if you don’t know the result, we can collect the result from General office):

BSW: CumulativeGPA in2016:

MSW: Course(s) Result:

PreviousSocial Work Fieldwork Placement Experience:

 No

 Yes (Setting: Grade/Marks: )

Language Proficiency (please  where appropriate):

English / Cantonese / Putonghua / Other(specify):______
Good
Fair
Poor

Preference of Overseas/ Mainland Fieldwork Placement (refer to the information being posted on placement web-site):

1stChoice:

Reasons:

2nd Choice: Reasons:

3rd Choice:

Reasons:

Any other points that you would like to make to support your application? If yes, please provide the information.

Financial Declaration:

 I do not intend to apply for the following fund/subsidy

I intend to apply for the following fund / subsidy (can choose more than one):-

SWSA Alumni (1978 Graduates) International Fieldwork Placement Fund

(for all programs; to support most needy students with financial constraints)

 T Y Wong Foundation Fund (on loan with no interest) (for all programs, preferable to FT students)

 Other Self-explored source

Reasons for applyingfor the Funding Support:

Any other points that you would like to make to support your financial application?

If yes, please provide the information.

I have asked ______(Name of Teacher) to fill in Form B for me.

I declare that the information given in support of this application is accurate and complete.

Name of Student: Signature:

Date:

Deadline of Submission: On or before 23December 2016at 5:00pm

Enquiry:Mrs. Eltha Wongat 3917-5549 or

The University of Hong Kong FORM B

Department of Social Work and Social Administration

Overseas/MainlandFieldwork Placement 2017

Recommendation Form

Recommended Teacher:

Feedback on Student’s Performance (from Teacher):

(The applicant has to invite a teacher to make recommendation on his/her application. The applicant has to send this form together with the student’s application form to the teacher for comments. The teacher will return the application to the DDFI directly. The information provided by the teacheris for reference of the Selection Panel and will not be disclosed to the candidate)

Name of Student: Program of Study:

 I recommend the student to undertakethe overseas placement.

Reasons:

 I have reservation to recommend the student to undertake the overseas placement.

Reasons:

 I do not recommend the student to undertakethe overseas placement.

Reasons:

Name of Teacher:

Signature: Date:

Selection Criteria (for reference only):

  1. Good performance in selection panel interview and written test
  2. Great interest to take Overseas/Mainland fieldwork placement
  3. Outstanding academic performance (GPA at 3 or above is a necessary requirement)
  4. Recommendation by university teachers
  5. Essential qualities such as language proficiency (English and/or Putonghua), maturity, presentation, analytical thinking, adaptability, willingness to accept challenge and enthusiasm to help others
  6. Sufficient financial support to afford all necessary expenses incurred (students have financial difficulties will be supported by the Alumni Fund)
  7. Good health condition if required
  8. Clear criminal record if required

Enquiry:Mrs. Eltha Wongat 3917-5549 or