UNION COLLEGE SOCIAL WORK PROGRAM APPLICATION FOR CANDIDACY STATUS

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1 1 UNION COLLEGE SOCIAL WORK PROGRAM APPLICATION FOR CANDIDACY STATUS Personal Information Name: Date: Mailing Address: _ Phone: _ Date of Birth: Sex: Marital Status: Number of Dependents: General Health (circle one): Excellent Good Fair Poor Class (circle one): Freshman Sophomore Junior Senior Do you have any diagnosed conditions that the Social Work Program or Field Agency should take into account for placement purposes? If so, describe: Academics If you are behind in the social work major s suggested sequence what is your plan of correction? When is your tentative date of graduation? If you do not meet the minimum cumulative GPA requirement of 2.5 what is your plan to increase your GPA to meet field requirements?

2 2 Criminal Record Have you ever been arrested for any crime? Yes No Have you ever been convicted of a felony or misdemeanor? Yes No Give dates and detail of offense(s) I verify that the above information is complete and accurate. Signed: Date: Ethical Statement: I have received a copy of the National Association of Social Workers Code of Ethics. I have read, understand, have been given the opportunity to ask questions, and I agree to abide by this Code of Ethics. I acknowledge that I may be terminated from the Union College Social Work Program if in the professional judgment of the social work faculty, a violation of this code occurs. Signature: Date: Resume Please attach a resume that includes education (high school and college information), work and volunteer experiences, extra curricular activities, leadership experiences, professional development, and awards. Candidacy Essays Type up the following questions and staple a printed copy of your answers to the application: Career 1. What are your reasons and motivations for choosing social work as a profession? 2. What are your short and long term career and life goals? Identify as a Professional Social Worker 3. Identify and explain the social work role(s) which you feel most connected. 4. Describe what qualities are important to be an effective social worker? 5. Which of these qualities do you now possess and which do you need to develop further? Social & Economic Justice 6. What is a social or economic injustice that is currently confronting the United States and how can social work meet those societal needs? Diversity

3 3 7. What experiences have you had which make you think that you can work effectively with people from diverse populations that reflect differences in religion, race, ethnicity, physical and mental abilities, age, gender, socioeconomic status, sexual orientation, and gender identity? 8. What experiences have you had that might present difficulties in working with any of the groups listed above? Spiritual Teaching 9. Discuss a scriptural passage that has encouraged you in your path as a social worker. Reference Forms Two references should be made by faculty or staff of Union College, the third may be filled out by a work supervisor, pastor, dean, or other personal reference.

4 4 UNION COLLEGE SOCIAL WORK PROGRAM RECOMMENDATION FORM To be completed for students who wish to become a candidate in the Social Work Program. Candidate: _ Date: Recommender: Title: Note to the Recommender: Please return the completed recommendation forms to: Union College Social Work Program 3800 South 48 th Street Lincoln, NE Fax: Quality of scholarship Leadership skills Initiative in work Sense of responsibility Attention to details Ethical conduct in the classroom or workplace Attendance and punctuality Participation in student activities Ability to meet/engage people Emotional stability Maturity as compared to peers Grooming Respectful of diverse populations Ability to work with others Enthusiasm Poor Below Above Superior Quality Unknown Do you feel comfortable recommending this person to the field of social work? Yes, without reservation Yes, with reservation* No* *Please explain in the section below. Comments/Concerns:

5 5 Recommender s Signature: The Social Work Program reserves the right to follow up with the recommender on any identified comments or concerns. UNION COLLEGE SOCIAL WORK PROGRAM RECOMMENDATION FORM To be completed for students who wish to become a candidate in the Social Work Program. Candidate: _ Date: Recommender: Title: Note to the Recommender: Please return the completed recommendation forms to: Union College Social Work Program 3800 South 48 th Street Lincoln, NE Fax: Quality of scholarship Leadership skills Initiative in work Sense of responsibility Attention to details Ethical conduct in the classroom or workplace Attendance and punctuality Participation in student activities Ability to meet/engage people Emotional stability Maturity as compared to peers Grooming Respectful of diverse populations Ability to work with others Enthusiasm Poor Below Above Superior Quality Unknown Do you feel comfortable recommending this person to the field of social work? Yes, without reservation Yes, with reservation* No* *Please explain in the section below. Comments/Concerns:

6 6 Recommender s Signature: The Social Work Program reserves the right to follow up with the recommender on any identified comments or concerns. UNION COLLEGE SOCIAL WORK PROGRAM RECOMMENDATION FORM To be completed for students who wish to become a candidate in the Social Work Program. Candidate: _ Date: Recommender: Title: Note to the Recommender: Please return the completed recommendation forms to: Union College Social Work Program 3800 South 48 th Street Lincoln, NE Fax: Quality of scholarship Leadership skills Initiative in work Sense of responsibility Attention to details Ethical conduct in the classroom or workplace Attendance and punctuality Participation in student activities Ability to meet/engage people Emotional stability Maturity as compared to peers Grooming Respectful of diverse populations Ability to work with others Enthusiasm Poor Below Above Superior Quality Unknown Do you feel comfortable recommending this person to the field of social work? Yes, without reservation Yes, with reservation* No* *Please explain in the section below. Comments/Concerns:

7 7 Recommender s Signature: The Social Work Program reserves the right to follow up with the recommender on any identified comments or concerns.

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