social work program - liberty university€¦ · web viewsowk 101 introduction to social work sowk...

Hybrid Program Option

Bachelor of Science in Social Work

Gate One Application

2015-2016

2016 - 2017

LU SOWK Hybrid Gate One Application Packet

GATE ONE ADMISSIONS REQUIREMENTS CHECKLIST

Complete and submit a Summary of Prerequisites (page 3) showing completion of at least 30 semester hours of the general education requirements, with a grade of C or higher in the following prerequisites:

SOWK 101 Introduction to Social Work

SOWK 135 Social Work Field Exploration and Observation

PSYC 101 General Psychology

SOCI 200 Introduction to Sociology

SOWK 260 Chemical Dependency

SOWK 270 Ethics in Professional Helping

BIOL 101 General Biology

Earn a cumulative GPA of 2.5 or better. Submit a copy of your Degree Completion Plan Audit (DCPA) from CRM. Make sure your DCPA is current. (Students must have a C or better in all social work classes).

Complete and submit the Gate One Application to the social work office, including an Autobiographical Statement detailing your interest in social work.

Please also note that certain laws and judicial actions override our commitment to mutual confidentiality. These include mandated reporting of physical or sexual abuse of children, incapacitated adults and elders, threats of suicide or homicide, and other statutes required by law. Please consult your ethics codes and state policies for further information. Additionally, university policy requires faculty to contact the Title IX Office when a student reports past or present abuse. In cases like this, your privacy will be respected by the Title IX office; however, you will be contacted by them so they can offer you supportive resources.

Submit completed Volunteer Log indicating a minimum of 10 hours of work at a social service agency.

Submit results of Background Check

Submit three Letters of Recommendation.

One must be from a volunteer supervisor required

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SUMMARY OF PRE/CO-REQUISITES

Name: ________________________________________________________________________

ID#: __________________________________________________________________________

Advisor: _______________________________________________________________________

Cumulative GPA: _____________________________________ (must have a 2.5 or better)

Date: _____________________ Signature: ___________________________________

PREREQUISITE COURSES: Please indicate grade received for these required courses. A grade of C or better is required for each of these courses. (IF A COURSE HAS NOT BEEN TAKEN, PLEASE PUT DOWN WHEN IT WILL BE; INDICATE IF WAIVED or Course Substitution was permitted).

1. ________ SOWK 101

2. ________ SOWK 135

3. ________ SOCI 200

4. ________ PSYC 101

________ BIOL 101

_________ SOWK 260

_________ SOWK 270

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GATE ONE ADMISSIONS APPLICATION

_________________________________ ___________________________________ (Name) (Email)

_______________________________ ___________________________________ (Present Address, City, Zip) (Permanent Address, City, Zip)

________________________ Do you text and receive texts on your cell phone? ________(Cell Phone)

EDUCATION

________________________________________________________(Name of High School)

_________________________________________________(City, State)

__________________________(Graduation Date)

____________________________________________________________________________(Name of other Colleges attended)

_________________________________________________(City, State)

_________________________________________________(Expected Date of Graduation from Liberty University)

4

EMPLOYMENT HISTORY

(Place of Employment—present or most recent) Dates of Employment

Responsibilities: ______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

(Place of Employment—previous) Dates of Employment


______________________________________________________________________________

______________________________________________________________________________



______________________________________________________________________________

______________________________________________________________________________


Responsibilities: _______________________________________________________________

______________________________________________________________________________

5

Volunteer Log

DATE HOURSLOCATION (CITY, STATE, COUNTRY)

AGENCY SUPERVISOR

6

EXTRACURRICULAR ACTIVITIES

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

PERSONAL INFORMATION

My strengths:

I use my strengths in these situations:

Areas where I recognize I need to improve:

I am attempting to grow in these areas by:

My career interests upon graduation are:

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OTHER PERTINENT INFORMATION

Is there any additional information you would like to share that would help us maximize your experience?

______________________________________________________________________________

______________________________________________________________________________

Transportation Plan for Field Experience

______________________________________________________________________________

______________________________________________________________________________

Driver's license (check one): YES NO

Insured car available (check one): YES NO

In case of emergency, notify:

Name Phone Number ___________________________

Address _______________________________________________________________________

City _________________________________________________________________________

State ______________________________________ Zip __________________________

Email _________________________________________________________________________

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Disclosure Statement Form

Please answer the following questions to assist the field education staff of the Department of Social Work in securing an appropriate field experience for you.

1. Have you been charged or convicted of any misdemeanor or felony charge or named as a perpetrator of a founded report of child abuse or neglect?

Yes ______________ No_______________

If yes, please explain: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Is there any information concerning personal or family issues (including behavioral issues), illnesses, or addictions that could impair your ability to function well in a social work capacity for a particular agency or with a particular population? This could include, but is not limited to, drug or alcohol abuse, domestic violence, child abuse, or economic issues.

Yes ______________ No_______________

If yes, please explain: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

No arrangements for a field placement will be made prior to completion of this statement and its submission to the Department of Social Work.

I confirm that my responses to the questions in this form are true and I hereby grant permission to the field education staff of the Department of Social Work to release information from this form for the purpose of arranging my field

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placement. This release extends only to a mutually agreed upon agency or party for the purpose of a mutually agreeable placement.

I agree to immediately inform the Director of Field Education if during my junior or senior field internship, I am charged with a felony or a misdemeanor.

Student Signature: __________________________________Date_______________________________

AUTOBIOGRAPHICAL STATEMENT

Please type and attach to the application a statement that will allow the Social Work Department to understand more fully your interest in this field of education (four to five pages). Please include the following information in your narrative.

1. Your family and significant family relationships.

2. Your life experiences, which have shaped your desire to go into social work.

3. Your experiences in helping people, including those with backgrounds and characteristics different from your own. How well do you deal with diversity and value differences? You will need to commit to providing compassionate and effective help to all people. Are there any people you could not commit to learning how to help? Support your responses with examples.

4. Your career goals and plans for achievement.

5. Address how Micah 6:8 applies to the practice of social work.

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LETTER OF RECOMMENDATION FOR SOCIAL WORK EDUCATION

Students: Please complete the top portion of this form prior to providing the entire form to your recommender.

Name of Student ____________________________________________________________

Name of Recommender _______________________________________________________

Role of Recommender______________________________ Length of Relationship _________

Address of Recommender _________________________________________________________

The Family Educational Rights and Privacy Act (FERPA) provides individuals with the right to view statements of recommendation. However, you may waive your right to review this recommendation. Please indicate if you are waiving your right to view this recommendation.

I waive my right to view this recommendation I do not waive my right to view this recommendation

Signature of Student ________________________________________________________

______________________________________________________________________________

Completed by the Recommender

The above named person is applying to the social work program at Liberty University. Please include your recommendation and comments regarding the applicant in any of the following areas of which you have knowledge: intellectual capacity, ability to work with diverse people, professional abilities, ability to perform under pressure, areas of needed growth, and sensitivity to people. You may write on the back of this form if you need more room.

Your recommendation:

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In what capacity and for how long have you known the student?

Please rate this student in terms of his/her overall potential for the practice of professional social work:

1. Excellent 2. Above Average 3. Average 4. Below Average

Additional Comments ____________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Name (please print) ______________________________________________________________

Position and Title _______________________________________________________________

Address ______________________________________________________________________

Date _______________ Signature _________________________________________________

Please return this form to the Social Work Department, Liberty University, 1971 University Blvd, Lynchburg, VA 24515 or scan and email to [email protected]. If you have questions, you can reach the faculty support coordinator for the social work program at the same email address.

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mailto:[email protected]

GATE ONE INTERVIEW FORM

Completed by the Student

Name of Student ____________________________________________________________

The Family Educational Rights and Privacy Act (FERPA) provides individuals with the right to view statements of recommendation. However, you may waive your right to review this recommendation. Please indicate if you are waiving your right to view this recommendation.

I waive my right to view this recommendation I do not waive my right to view this recommendation

Signature of Student ________________________________________________________

Please also note that certain laws and judicial actions override our commitment to mutual confidentiality. These include mandated reporting of physical or sexual abuse of children, incapacitated adults and elders, threats of suicide or homicide, and other statutes required by law. Please consult your ethics codes and state policies for further information. Additionally, university policy requires faculty to contact the Title IX Office when a student reports past or present abuse. In cases like this, your privacy will be respected by the Title IX office; however, you will be contacted by them so they can offer you supportive resources.

Date and Time of Interview ___________________________________________________

Interviewer(s) ______________________________________________________________

1. Student’s personal testimony and family history

2. Student’s awareness of personality traits (strengths and areas of needed growth)

3. Student’s goals

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4. Student’s understanding of social work roles

a. What are the roles?

b. What roles do you see yourself in?

5. Student’s comparison of and contrast with personal values and social work values

a. What are the social work values?

b. Do any of the social work values conflict with your worldview? If yes, describe.

Interviewer(s) Recommendation/Assessment:

Student’s verbal communication skills

Student’s appearance (professional?)

Student’s presentation of self

Any noted areas of concern

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Gate One Admission Recommendation:

Pass through Gate One

Gate One Provisional Procession

Delay Gate One Procession

Deny Gate One Procession

If Gate One procession is delayed, please detail the reason for delay.

If provisional procession is granted, indicate what steps need to be taken to pass through Gate One.

Name: __________________________________________________ Date: ______________(Faculty Interviewer)

Name: __________________________________________________ Date: ______________(Faculty Interviewer)

Reviewed: _______________

Name: ___________________________________________________ Date: ______________ (Program Director)

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