Field Placement Form 

Welcome to the USC School of Social Work! 

 

For incoming students: 


In order for you to be placed in an MSW internship, you will need to complete and submit this entire Online Field Placement Form within five days of receiving your intent to enroll form. Your intent to enroll/enrollment confirmation form (including Field Education Contract and Background and Clearance Form), commitment deposit, and this field form are required to secure your place in the upcoming class. 


For continuing students:


In order for you to be placed in an MSW internship, you will need to complete and submit this entire online Field Placement Form in a timely manner; otherwise, your field placement may be delayed and your ability to ultimately graduate with your cohort may be negatively impacted.


Please complete all areas, as this information will be used to guide the Field Education Placement Team in developing your community-based field placement. Some of this information will also be sent to your assigned Field Instructor to assist in planning your educational experience.


If you have any further questions, please call 213-740-9416 or email sswfield@usc.edu. If there are any changes to your academic year address, please contact the Field Education Department at sswfield@usc.edu.


Thank you for taking the time to complete this form thoroughly. We look forward to working with you in the MSW program. Fight on!


Page 1 of 5

Personal Information

Geographic proximity between your address during the academic year and your internship location is an important consideration in the placement process.  For this reason, the Field Placement Team does not begin the placement process until you have provided your full address. Failure to provide your full address in a timely manner may result in a delay to the start of your placement. 

Emergency Contact

Language Fluency

Transportation

Substantial travel (typically within 30 miles or up to 1 hour) may be required to your field placement site on a reoccurring basis; therefore, current automobile insurance may be required.  If a different geographic area and/or proximity of field placement to home is important, please explain why. Keep in mind that any travel limitations may affect the placement options available to you, create significant delays in placement, and impact your ability to graduate with your cohort.



Page 2 of 5

Military Affiliation

Education Summary

Work Experience

Please list and briefly describe previous experience (volunteer and paid) related to social work. The information requested below will assist in the planning of your field assignment. Please also include a copy of your current resume. Your resume and field application will be shared with potential placement site(s).

Field Placement Schedule


The following is a list of populations and clinical issues that you may be working with during your field placement: adolescents, adult women, adult men, children and families, older adults, AIDS, Alzheimer's, cancer, child abuse, child and family protective services, corrections/criminal, developmental disabilities, domestic violence, emotionally disturbed children and/or adolescents, family service, LGBT, health/medical, homelessness, juvenile delinquency, mental health, public social services, severe mental illness, social work in schools, substance abuse and veterans.

Page 3 of 5

Program Focus

General Information
Please review the 3 departments described below and select the one that best matches your professional social work interest.  Please note: Once you enter your community field placement, department change requests will only be reviewed on a case-by-case basis. Please thoroughly review all material and information prior to making this important choice.Adult Mental Health and Wellness (AMHW) 


Adult Mental Health & Wellness (AMHW)   
Adult Mental Health and Wellness prepares students to improve the mental health and physical well-being of individuals across the adult lifespan, from young adults to older adults. Students in this department are prepared to support adult clients within agencies, institutions, communities, families and other social and organizational contexts.
Read more here.


Children, Youth and Families (CYF) 
Children, Youth and Families prepares students to improve the lives and well-being of children, youth and their families. Students in this department are prepared to support children, adolescents and transitional age youth within agencies, institutions, communities, families and other social and organizational contexts.

Read more here.


Social Change & Innovation (SCI)  

Social Change and Innovation (SCI, pronounced “sky”) focuses on designing social change and leading innovation. The curriculum prepares students to improve living conditions and work environments for individuals, groups, families, organizations and communities on a larger scale.

Read here.



Page 4 of 5

Personal Statement

This personal statement asks for additional and different information than the personal statement you submitted with your original admissions application.  Please share information which we can use to plan your field education experience.
1. Provide an introduction of yourself.
2. Articulate why you chose social work.  Include personal growth experiences which have influenced your decision to pursue an advanced degree in social work.
3. Describe your expectations for your field placement; discuss particular interests, strengths, and limitations and how they might affect your ability to help clients.
4. Explain why you chose the specific USC School of Social Work department, including how this choice enhances your individual learning goals and career focus.
Note: This statement may be shared with the Field Instructor at your assigned placement.

Please be as detailed as possible. (10,000 character limit.  You may copy and paste.)


Supplemental Information:


Please answer the following questions to provide additional information that will assist the placement team in planning your field education experience. We cannot guarantee that you will be placed with a specific population or agency of your interest. Please be aware this information will be shared with agencies and field instructors outside of the School. You may be contacted by a Field Department team member should additional information be required.

 

The first year internship is a generalist practice experience focused on individuals, groups, and/or families. There may be some community/agency level experiences for Department of Social Change and Innovation students.

 

Please address the following:

 

1.     Describe the reasons/experiences that led you to enter the social work profession (1-2 paragraphs).

2.     What professional experiences and strengths will you bring to your field placement agency? (knowledge/skills/attitudes) (1-2 paragraphs).

3.     What are some areas of growth that you would like to learn and/or build upon during your first year internship? (1 paragraph).


(5,000 character limit. You may copy and paste from word processing program.)

Page 5 of 5