Present Address: Street City State Zip. (work)

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1 UMKC SCHOOL OF SOCIAL WORK APPLICATION FOR ADMISSION University of Missouri-Kansas City 5100 Rockhill Road Kansas City, MO Program Location: 5030 Cherry St, Cherry Hall 225 Kansas City, MO Phone: (816) FAX: (816) Name: Last First Middle Initial Present Address: Street City State Zip Permanent Address: (if different) Telephone: (home) (work) (Cell) Indicate to which program you are applying: Regular Program Advanced Standing Program (Restricted to B.S.W. graduates only.) Enrollment will be: Full Time Part Time Semester and year of anticipated enrollment: Fall 20 Summer 20 Spring 20 Midwest Student Exchange Program (MSEP): (See Page 3) Education List all colleges/universities attended. (Advanced Standing Only) School Location Major/Minor Dates Attended Degree (Advanced Standing Only) Social Work Experience List all social-services related employment, volunteer, civic, and field experiences. Position Agency or Company Location Dates Telephone Other Work Experience List any other recent or relevant employment or work responsibilities. Position Agency or Company Location Dates Telephone Other Qualifications List any additional qualifications, awards, honors, memberships, committees, or publications (with applicable dates) about which you would like us to know. 1

2 Narratives Instructions: You will need to provide a response to the two narrative sections below. Answer all questions under each heading with clear, logical, and reasonable responses. Provide appropriate examples and meet each section s page number requirements. The quality of the content of each narrative section will be used to determine the applicant s preparedness for professional graduate social work education. Statement of Values and Ethics Attach a brief essay (2-5 typewritten, double-spaced pages) in which you address the following: The NASW Code of Ethics may be found at: Discuss your purpose for pursuing a Master s in Social Work. Compare and contrast your personal value framework with the NASW Code of Ethics values and principles. In light of the Code of Ethics, what human needs do you hope to address as a professional social worker? In light of the Code of Ethics, how will you infuse all of the six ethical principles into your future social work practice? Describe a personal life experience that challenged your values and ethics. How did you respond to this challenge? Preparation for Professional Training Please provide complete answers to all of the points below, including specific examples (2-5 typewritten, double-spaced pages). Please explain any particular difficulties or successes in your undergraduate academic career. How would you evaluate your academic experience up to this point in time? Identify how you have managed the personal and professional challenges in your life. What social supports do you have in place (or you can put in place) to assist with managing work, family and academic commitments? Identify the areas in which you need further academic and personal development. References Use the forms provided to supply three professional references. Include a person able to judge your potential for social work (a social worker who has supervised you, an employer, or field instructor) and a person able to judge your academic potential. If any of your references choose to write a letter, please also ask them to complete the rating scales on the reference forms. Resume Please include a copy of your current resume. Read Carefully: The School of Social Work works closely with agencies in the community to provide quality practicum placements. An increasing number of these agencies are requiring practicum students to submit to background checks that can include, but are not limited to: criminal background checks, fingerprinting, and drug testing. The screenings are arranged directly between the students and the interviewing agencies. The School of Social Work does not pay for any fees associated with the screenings. While past experiences do not limit an applicant s acceptance into the program, some experiences may severely limit placement opportunities. The School Of Social Work makes individualized placements that are coordinated with the agency. I certify the information on this application is accurate and complete. I understand that all required credentials must be submitted before an admission decision may be made. I authorize the University of Missouri-Kansas City to maintain all of my records under my signature name, and I understand these records and credentials in support of my application are the property of UMKC and may not be returned or reproduced. Date Signature For assistance with your application to the UMKC M.S.W. Program, please call the School of Social Work at (816) PLEASE REFER TO PAGE 3 OF THIS APPLICATION FOR ADDITIONAL INSTRUCTIONS. 2

3 Application Checklist Please refer to the following checklist before sending materials: SEND TO THE SCHOOL OF SOCIAL WORK: Social Work Application for Admission Statement of Values and Ethics Preparation for Professional Training Narrative Resume Reference Forms (3) submitted with application. References are submitted with the name of the applicant written across the flap of the envelope. If your references write a letter, please also have them complete the rating section of the reference form. Mailing Address: University of Missouri-Kansas City School of Social Work 5030 Cherry St Cherry Hall Room 225 Kansas City, MO SEND TO THE UMKC OFFICE OF ADMISSIONS: All undergraduate and graduate transcripts University Application for Admission- Go to to begin the online application process. Application fee Mailing Address: UMKC Office of Admissions, 120 Administrative Center, 5100 Rockhill Road, Kansas City, MO *You must personally request transcripts from previous schools you have attended. Requests for official transcripts should be made as soon as possible to ensure timely receipt of these documents. In addition, applicants who either currently attend, or have attended, UMKC must make a new request for transcripts to be reported to the School of Social Work. For transcript assistance, please call (816) Individuals with speech or hearing impairments may call Relay Missouri at (TT) or (voice). Application Deadlines: Advanced Standing (BSW applicants only) October 1 to begin courses in Spring Semester February 1 to begin courses in Summer Semester Standard/ Traditional Program March 1 to begin courses in Fall Semester Midwest Student Exchange Program (MSEP) is an interstate initiative established by the Midwestern Higher Education Commission to increase educational opportunities for students in its member states. MSEP enables residents of Kansas, Michigan, Minnesota, Missouri, Nebraska and North Dakota to enroll in designated institutions and selected programs outside their home state at reduced tuition levels. 3

4 UMKC SCHOOL OF SOCIAL WORK THE POWER OF SOCIAL WORK UMKC School of Social Work Admission Requirements A. Standard/ Traditional Program (60 Graduate credit hours) 1. A baccalaureate degree 2. A minimum cumulative GPA of at least 3.0 is preferred; or a GPA of at least 3.0 for the last 60 credit hours of the baccalaureate program. Note lower GPA s will be considered for provisional admission (see socialwork). 3. The GRE is NOT required. 4. Three professional or academic references who can assess your potential for graduate study in social work. 5. Attach your resume. B. Advanced Standing Program (36 Graduate credit hours) 1. A BSW degree earned within the last 5 years. 2. A minimum cumulative GPA of at least 3.0 is preferred; or a GPA of at least 3.0 for the last 60 credit hours of the baccalaureate program. Note lower GPA s will be considered for provisional admission (see socialwork). 3. The GRE is NOT required. 4. Three professional or academic references who can assess your potential for graduate study in social work. One reference must be from your Field Instructor, Field Liaison, or the Director of Field. 5. Attach your resume. STATEMENT OF HUMAN RIGHTS The Board of Curators and UMKC are committed to the policy of equal opportunity, regardless of race, color, creed, sex, sexual orientation, age, national origin, disability, or Vietnam-era Veteran status. The Affirmative Action Office, 360 Administrative Center, 5115 Oak St., is responsible for all relevant programs. Call (816) for information. Relay Missouri: (TT) or (voice). STUDENTS RIGHT TO KNOW In accordance with Public Law , UMKC reports 72 percent of its first-time freshmen return the second year. The UMKC Police Department publishes an annual campus report on personal safety and crime statistics. The report includes statistics for the previous three years concerning reported crimes that occurred on campus; in certain offcampus buildings owned or controlled by UMKC; and on public property within, or immediately adjacent to and accessible from the campus. The report also includes institutional policies concerning campus security, such as policies concerning alcohol and drug use, crime prevention, the reporting of crimes, sexual assault and other matters. The report is available at or at the UMKC Police Department, 5005 Oak St., Kansas City, MO

5 REFERENCE FORM UMKC SCHOOL OF SOCIAL WORK To the Applicant Your name First Last Middle Initial (1) Please request references from three people who have recent knowledge about your qualifications. Include employers, faculty members, and others who can make informed statements about your readiness for a graduate academic program and your potential contributions to the field of social work. (2) Include this form and a self-addressed, stamped envelope to each of your references and ask that they send it back to you after signing across the seal. (3) When you have received all three envelopes, send them together with your application to the UMKC School of Social Work. Under the Family Educational Rights and Privacy Act of 1974, University students have the right to inspect their files upon request. Please sign one of the statements below so that the person writing this recommendation will know whether it will be held in confidence or whether it will be open to your inspection upon request. I retain the right to read this recommendation. I waive my right to read this recommendation. Signature Date Signature Date To the Reference The above named person is applying for admission to the M.S.W. program at the University of Missouri-Kansas City School of Social Work. We appreciate your candid comments about the applicant s suitability for graduate study and the field of social work. Your name Date Position/Title Organization Address Street City State Zip Phone In what capacity have you known the applicant and for how long? Please respond to the following questions. You may use this form, or additional pages may be added if needed. (1) Do you know of any matters pertaining to character, integrity, ability to accept responsibility, or related condiderations, that should be made known to the Admissions Committee?

6 (2) To what degree does this applicant have a commitment to social justice and concern for others? (3) Assess this person s academic potential and ability to succeed in a graduate program. Academic performance Motivation Ability to work with others / flexibility Verbal skills Writing skills Critical thinking skills Respect for differences Exceptional Superior Good Average Below Average Unable to Rate Creativity Leadership potential (4) What is this candidate s potential for leadership, and capacity for growth/development? (5) What is your estimate of his/her promise as a graduate student? (6) To what degree does this applicant have a commitment to diversity, for example, sexual orientation, race, ethnicity, gender, mental and physical abilities. (7) Circle the level of your overall recommendation of this person. Enthusiastic Strong Moderate With Reservations Not at this Time Signature Thank you for your time. Enclose this reference in the self-addressed, stamped envelope and return to the student applicant after signing across the seal.

7 UMKC SCHOOL OF SOCIAL WORK THE POWER OF SOCIAL WORK Advanced Standing ONLY: Please provide a 3-5 page, typewritten, double-spaced response to the following: Provide an overview of your field practicum experiences. Describe lessons learned from your field experiences. Provide specific examples. How do you think these lessons learned will affect your future social work field experiences? In relation to the social work profession, what areas do you need to further your personal and professional growth? STATEMENT OF HUMAN RIGHTS The Board of Curators and UMKC are committed to the policy of equal opportunity, regardless of race, color, creed, sex, sexual orientation, age, national origin, disability, or Vietnam-era Veteran status. The Affirmative Action Office, 360 Administrative Center, 5115 Oak St., is responsible for all relevant programs. Call (816) for information. Relay Missouri: (TT) or (voice). STUDENTS RIGHT TO KNOW In accordance with Public Law , UMKC reports 72 percent of its first-time freshmen return the second year. The UMKC Police Department publishes an annual campus report on personal safety and crime statistics. The report includes statistics for the previous three years concerning reported crimes that occurred on campus; in certain offcampus buildings owned or controlled by UMKC; and on public property within, or immediately adjacent to and accessible from the campus. The report also includes institutional policies concerning campus security, such as policies concerning alcohol and drug use, crime prevention, the reporting of crimes, sexual assault and other matters. The report is available at or at the UMKC Police Department, 5005 Oak St., Kansas City, MO