Stockton University Social Work Program field education application and information

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Stockton University Social Work Program



In the spring semester, you will be introduced to field education through a combination of coursework, field visits as a group, a structured interview, guest speakers and assignments. You will be introduced to different types of social work and differing roles among social work professionals in these agencies. You will be prepared in foundational competencies including professionalism, engagement skills, cultural competency, application of ethical standards, and recognition of social justice issues. This .internship application will introduce you to the Coordinator of Field Education, Douglas Deane, and the two Assistant Coordinators of Field, Hilda Rivera and Christine Lill. Your demographic information, geographic preferences, social work areas of interest and essay answers will allow the field education program to assess your learning needs and experience. At the beginning of next semester, you will sign up for 2 mandatory field trip days. At your third Practicum Fieldwork class, you will be assigned a social worker at an agency who you are expected to contact to set up a pre-placement interview. You will be evaluated as to your readiness for a senior internship through a structured interview assessing your demonstration of the 5 foundational competencies. If evaluated favorably, this will be your 400 hour senior internship beginning next fall.

You will complete and submit your application on TK20 no later than December 1st, 2015. Faculty will review your application and notify you of your assigned internship agency with whom you will interview at the third meeting of Practicum Fieldwork in the spring. We are interested in what type of agency you prefer, what geographic area you prefer, and any additional information that you feel the Field Office should know in order to place you in an agency that meets program requirements and your preferences as closely as possible.

The majority of internship are available during weekday and day time hours. Internships are learning experiences that support the integration of classroom knowledge with applied experience and are supervised by a professional field instructor. Frequently this supervision is not available during evening or weekend hours in agencies. It is therefore the responsibility of students to accommodate their schedules to internship availability. Students are not allowed to arrange their own internships. Internships where students are employed must be pre-approved by the Field Office and meet Council on Social Work Education requirements and additional documentation is required. Please read and review our Field Manual on the social work website for all policies related to field education.

Your completion and submission of this application is your first field education assignment. Therefore, it should be professionally presented, complete, thorough, and submitted on time. Late applications will not be accepted meaning that you cannot proceed with the junior sequence in the spring semester. It provides Field Education with a first impression of your ability, as well as demonstrates your readiness to enter the field as a social work intern. Your essay answers should reflect your experience and self-awareness as to why you are pursuing a career in social work.


Directions: Complete and submit this application on TK20. It can be found at or type in the go portal. Then click the top tab entitled “Application.” You will need to purchase and activate a TK20 account prior to doing this. There are instructions on the Log-In page. Your username and password for the go portal works for TK20 also.

Student Name: _________________________________ Date Completed: ________________

Address: ____________________________________________________________________________

____________________________________________________________________________ City State Zip Code

Telephone Number: _____________________________ Cell Number: _________________________

Stockton E-Mail Address: ________________________________________________________________
Fall 2014 Theory & Methods’ Instructor: _______________________________________
Are you fluent in a language other than English? _____ Yes _____ No
If yes, specify: _________________________________________________________________
Transportation Concerns (For example, no car, limited to public transportation, etc.):
Geographic Preferences (List first three counties of choice with a 1, 2 and 3):

Atlantic____ Burlington_____ Camden____ Cape May____ Cumberland_____ Gloucester____

Monmouth_____ Ocean_____ Salem _____ Other____


Your signature verifies that you have read the Field Manual as you are responsible for understanding and adhering to the policies stated therein: _____________________

Human Service Setting Preferences (Please list 3 general types of agencies. For example, family services, mental health, school, medical, corrections etc.):




Are you a U.S. citizen? _____ Yes _____ No Are you a legal resident? _____ Yes _____ No

Will you be pursuing?

Child Welfare Concentration ______Yes _____ No

Gerontology Minor _____ Yes _____ No

Are you a student with a disability and wish to request accommodations in your field placement? All accommodations must be outlined specific to field placement and verified through official documentation provided by the Learning Access Center. Please advise of the accommodations requested in the space below: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Are you a student with a criminal record and/or history of child abuse charges and wish to disclose in order to facilitate placement in a field internship where these factors will not impose restrictions in your internship? You are under no obligation to disclose this information. However, such disclosure, if made during the application process will help the field office in making an appropriate internship arrangement on your behalf.



Self-Assessment (Be accurate as your answers will be compared with those of your current professors)

How often do you edit your assignments before submitting (including peers, advisors, writing center)?

0________ 1-3 times_____ 4 or more_____

Do you ask for help when overwhelmed, uncertain or stressed? If yes, how often per week?

No______ Yes, 1-3 times per week_______ Yes, 4 or more times per week_______

How confident are you that social work is a good fit for a career?

Extremely Confident_______ Fairly Confident_______ Not Confident at All ________

How confident are you as to your readiness to successfully intern in the field?

Unsure______ Moderately Ready________ Prepared __________

How frequently are you late for class and/or in submitting assignments?

Never_________ Sometimes_________ Often_________

Consent for Release and/or Exchange of Student Information
I hereby authorize The Richard Stockton College of New Jersey, Social Work Program, field coordinator, field staff, and faculty to share pertinent personal information particularly criminal background, felony convictions, physical health, mental health, and/or disability status for the purpose of securing and/or maintaining an internship that meets Social Work Program standards with field agency representatives and field instructors as appropriate.

I understand that this information will be used solely for the purpose noted above and to fulfill my own educational needs to achieve professional competencies. This consent is in effect for the duration of my admission to the Social Work Program unless revoked in writing. I hereby hold harmless the field coordinator, field staff, and faculty and The Richard Stockton College of New Jersey from and against any and all claims resulting from the release and/or exchange of information about me during or after the completion of my academic program.

Option #1. I consent to the release and/or exchange of personal information as noted above:

____________________________________ __________________________

Student’s Signature Date

____________________________________ ____________________________

Witness Date

Option #2. I do not consent to the release and/or exchange of personal information as noted above:

____________________________________ ____________________________

Student’s Signature Date

____________________________________ ____________________________

Witness Date

This application should be completed on TK20.

Stockton University

Social Work Program

Field Internship Application & Program Admission Essay


You are formally applying for acceptance in the Social Work Program by completing the Junior Field Internship Application. In order for the faculty to get to know you better and your interest in social work, we are requesting a self-assessment essay that describes your professional development and current interests. Hopefully this will enable you to thoughtfully examine your career choice in the profession of social work, your strengths and weaknesses, and the learning tasks you feel you should focus on during the upcoming semester. Please type, using 12 point font and double space, your answers to the following questions in essay format:

  1. What do you think is the purpose of social work in society? How is this purpose expressed in what social workers do?

  1. What aspect of social work appeals to you? Why? What aspect of social work does not appeal to you? Why?

  1. Describe any personal experiences that significantly influenced you to become a social worker (e.g. family, friends, significant adults, personal problems, political issues, religious convictions, job market).

  1. Have you had any work, volunteer, or county college internship experience in social work? Describe its relevance to your learning and preparation for the field?

  1. What personal qualities do you possess that will aid you in becoming a social worker? What personal qualities do you possess that might hinder you in becoming a social worker?

  1. Are there any limitations or challenges (health, employment needs, financial circumstances, family problems) which may affect your involvement in full time studies and hinder your ability to complete field internships?

  1. In what ways will an internship prepare you as a social worker and as a professional?

This application should be completed on TK20.
Douglas Deane, Coordinator of BSW Field Education

Stockton University, Social Work Program

Office H-223

Mailbox H-201

(609) 626-3562

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