BSW Field Education Forms

Appendix A - Reference Materials & Forms

Nondiscrimination Policy

Harassment Policy

A 01 - Organization Profile

A 02 - Field Instructor Application

A 03 - Agency Placement Decision Form

A 04 - Affiliation Agreement

A 05 - Disclosure Form

A 06 - Field Placement Agreement

Accident Insurance Form & Health Brochure

Appendix B - Assignments, Instructions, and Syllabi

B 01 - Field Instructor Check-List for Student Agency Orientation
B 02 - Report on Community Visit
B 03 - Informational Visit to a Local Self-Help Group
B 04 - Guidelines for the Agency Orientation Summary Report
B 05 - Learning Contract Format
B 06 - BSW Field Placement Timesheet
B 07 - Weekly Log Guidelines
B 08 - Guidelines for the Learning Portfolio
B 09 - BSW Practicum Weekly Supervision Agenda
B 10 - Annotated Reading File
B 11 - Annotated Resource File
B 12 - Social Work Roles & Performance Standards

Fall 2011 Syllabi - SWK A495A, Section 601 and 602

C 01 - Field Education Communication Rating Scale
C 02 - Student End of First Semester Self-Assessment
C 03 - Field Instructor Assessment of Student
C 04 - End of Placement Competency Assessment Paper (CAP)
C 05 - Agency Evaluation of the BSW Field Education Program
C 06 - Student Evaluation of the BSW Field Education Program