CALIFORNIA STATE UNIVERSITY, CHICO SCHOOL OF SOCIAL WORK MSW TITLE IV-E CHILD WELFARE TRAINING PROGRAM

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1 CALIFORNIA STATE UNIVERSITY, CHICO SCHOOL OF SOCIAL WORK MSW TITLE IV-E CHILD WELFARE TRAINING PROGRAM INSTRUCTIONS FOR APPLICANTS 2013/2014 Academic Year EXTENDED DEADLINE: May 14, 2013 For more about the Title IV-E Program visit to download a link to a PowerPoint with more information. Dear Applicant: The Title IV-E Child Welfare Training Program staff would like to make the application process as user friendly as possible. However, Title IV-E has numerous requirements that stipend recipients must meet. We ask that you read these instructions carefully to make certain that you provide the required information. The Title IV-E program is designed for people interested in working in Public Child Welfare. Students will be notified as soon as possible as to the date of their interview. ELIGIBILITY REQUIREMENTS Please carefully read the requirements before agreeing to participate in the Title IV-E Child Welfare Training Program. 1. To be considered for the Title IV-E Child Welfare Training Program the applicant MUST: a. Be accepted in the two-year MSW program. b. Be accepted for Advance Placement (one-year program) c. Be accepted in the three-year Program and be an employee of a California County Child Welfare Agency. 2. Applicant must have a valid California driver s license and maintain it throughout the program. 3. Applicant must secure the use of a car for fieldwork; provide proof of automobile liability insurance, and current registration during the course of the program. 4. Applicant must maintain good standing during enrollment in the MSW Program and complete the MSW curriculum. Good standing is defined as maintaining a GPA of 3.00 or above*, and meet attendance requirements of each course. 5. Students must enroll in the FCY focus and successfully complete the Advanced Child Welfare (SWRK 687) and Substance Abuse (SWRK 677). *NOTE: If a student becomes academically ineligible, decides to separate from the program, or is convicted of a felony or misdemeanor, s/he may no longer be eligible to receive the stipend. If part-time s/he may lose

2 reimbursement support. As a result the student will be required to repay the cost of all financial support received with interest, including collection costs (if applicable) within 5 years. Program Options ADVANCED PLACEMENT (1 YR) 1. If awarded the stipend for 1 year, you will receive $18,500 based on the availability of funds. 2. Student must have completed an internship in a Public Child Welfare placement. 3. Students must enroll in the FCY focus and successfully complete the Advanced Child Welfare (SWRK 687) and Substance Abuse (SWRK 677). FULL-TIME PROGRAM (2 YRS) 1. If awarded the stipend for 2 years, you will receive $18,500 each academic year based on the availability of funds. 2. If you are employed by a California County Child Welfare Agency, you must negotiate a two-year leave of absence and submit the enclosed letter of support from your agency director/program manager. 3. Students must enroll in the FCY focus and successfully complete the Advanced Child Welfare (SWRK 687) and Substance Abuse (SWRK 677). PART-TIME STIPENDS 1. The part time stipends provide reimbursement based on the cost of tuition, books, mileage (to and from the University) and parking, based on availability of funds. 2. Cost of books are reimbursed after they are purchased each semester. Tuition will be paid for you directly by the Foundation. Travel reimbursement will be made at the end of each month. 3. Applicants must be employed by a California Child Welfare Agency or California Department of Social Services to participate in the Three-Year Program. 4. Employment payback must be with the sponsoring County unless there is no qualifying MSW position being offered upon graduation. PLEASE MAKE A NOTE OF THE FOLLOWING 1. Applicants for the stipend will be interviewed. Proposed interview dates: May 21, 23, and All academic requirements must be met by the beginning of the fall semester including the prerequisite courses in statistics and biology. 3. Stipend checks for Full Time Students are disbursed according to a schedule to be determined by the Research Foundation, and will be awarded as soon as funds are available, which will not be prior to tuition deadlines. 4. All stipend awards are contingent on the availability of federal funds. 5. A student may not be eligible to receive financial aid and the Title IV-E stipend. We are required to report the names of all students receiving the stipend to the Financial Aid Office. 6. Students must complete the Advanced Placement within one year, Full-Time Program within two years. 7. Students must meet the legal residency requirement. 8. Students must complete the field and seminar requirements.

3 POST-GRADUATE REQUIREMENTS Employment Payback 1. The student agrees to seek and accept appropriate employment in a California County Department of Social Services/Child Welfare Division or California Department of Social Services and to render one year of continuous and satisfactory full-time employment for each year of stipend support. The exception is that the 3 year program has a 2 year payback in accordance with the same number of units taken in the 2 year program. 2. Students will have six months from graduation to seek employment in a public child welfare agency within 75 miles of their home. If appropriate employment is not found within that timeframe, student must expand their job search statewide. Payback In lieu of Employment If a student or graduate supported by the Title IV-E Child Welfare Training Program is involved in any of the following, s/he may have to repay the stipend/reimbursement support with interest, plus collection costs over a five year period. Fails to satisfy complete academic and/or field requirements for the MSW degree. Violates the Code of Ethics of the National Association of Social Workers (NASW). Is convicted of a felony or misdemeanor. Voluntarily terminates the education program or post-graduate county employment. Refuses to apply for or accept employment in a California County Department of Social Services statewide.

4 APPLICATION CHECKLIST 1. Complete the Title IV-E Application. 2. Complete your Personal Statement. 3. Sign the Affirmation. 4. If a county employee: A Letter of Support should be completed, signed by your Agency Director/Program Manager. 5. Make a copy of all application materials for your records. 6. If you choose to mail your application, obtain a US Postal Service Certificate of mailing to document that your application packet was sent to CSU, Chico Title IV-E Program. Please mail or hand deliver only the Application, Affirmation, Personal Statement, and Letters of Support (if applicable) by the Deadline of May 14, 2013 at 5 p.m. to California State University, Chico School of Social Work Title IV-E MSW Child Welfare Training Program Butte Hall, Room 511 Chico, CA

5 SCHOOL OF SOCIAL WORK TITLE IV-E CHILD WELFARE TRAINING APPLICATION for MASTERS SOCIAL WORK TRAINING PROGRAM 2013/2014 APPLICATION APPLICATION DEADLINE: May 3, 2013 I am applying for (check only one) Advanced Placement 1 Yr. Full-Time 2 Yr. 3 Yr. Part-Time Program 1. Applicant Identification (Please type or print using black ink) Name: Last First Middle Last 4 digits of SSN: DOB: Ethnicity: Address while at school: Number Street City State Zip Permanent Address (if different): Number Street City State Zip Undergraduate Degree: Institution: Grad Date: Home Phone Work Phone Cell Phone Address: Person to contact in case of emergency: Address: Phones: Address: Alternate contact in case of emergency: Address: Phones: Address: Alternate contact in case of emergency: Address: Phones: Address:

6 2. Employment Are you currently an employee of any county public child welfare agency? [ ] Yes [ ] No If yes, please enclose a letter of support from your agency director or program manager, and identify your immediate supervisor and your job title. Job Title: Supervisor: Supervisor s Telephone: Public Child Welfare Years Non-Profit & Family Years Other Public Social Service Years 3. Language Skills In addition to English, are you fluent in another language? [ ] Yes [ ] No If yes, please indicate language: 4. Driver's License and Insurance California Driver's License Number: Expiration date: Automobile Insurance Company: Policy Number: Type of Coverage: Expiration date: Insurance Agent name & phone number: 5. Citizenship Are you a U.S. citizen? [ ] Yes [ ] No (a) If no, are you eligible to work in the US [ ] Yes [ ] No (b) Indicate your visa class: (c) Country of Citizenship: (d) Date of U.S. Entry:

7 6. Essay Questions: In 500 words or less for each question, please answer the following five questions. Reply to each question separately. Please type the answer to each question on a separate sheet of paper, double-spaced, 12- point font, with your name at the top of the page. Be very specific and clear in your answers. A. What lead to your interest in becoming a social worker and your desire to work within the public child welfare system? B. What are the personal strengths that you bring to this training opportunity? C. Are there any personal/family issues (religious beliefs, time commitments) or circumstances that might be obstacles to successfully completing this demanding fieldwork placement or work commitment? D. What is your understanding of the duties and responsibilities of a public child welfare worker? E. What is your understanding of the commitment involved in accepting a Title IV-E stipend? 7. Attachments included: If applicable, attach letter of support from Agency Director or Program Manager.

8 AFFIRMATION AND RELEASE OF INFORMATION Please initial each statement indicating that you have read and agree to the following: I agree to complete my field placement in a children's services agency and/or a public agency serving child welfare clients; I agree to have use of an automobile, a valid driver's license, and automobile insurance for bodily injury at all times during this program; I agree to be fingerprinted and to meet the criminal clearance requirements; I understand that I am obligated to pay back this stipend through a year of employment after graduation in a public child welfare agency for each year that I receive Title IV-E funds (3 year program 2 year payback). I hereby affirm that the above statements are true. I will agree to the provisions of the contract if granted the Title IV-E Child Welfare Stipend. Further, I give the Awards Committee of the Title IV-E Child Welfare Program permission to review my admissions application for entrance into the CSU, Chico, School of Social Work. I hereby attest that I have never been convicted of a felony or a misdemeanor crime involving harm to children. Note: The criminal background clearance will disclose felonies and misdemeanors. If you have questions about this aspect of the eligibility criteria, please contact Valerie Peck, Title IV-E MSW Program Coordinator at (530) I hereby attest that I have never been discharged from employment at a county or other social services agency due to violation of county code/merit system rules or violation of agency or professional code of ethics. Signature: Print Name: Date: