Please bring this completed form with when you come to lang house to write your essay



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Southern Connecticut State University

Social Work Department, BSW Program

Lang House, 101 Farnham Ave, New Haven CT 06515
BSW Program Application

DEADLINE: March 1, 2017

PLEASE BRING THIS COMPLETED FORM WITH WHEN YOU COME TO LANG HOUSE TO WRITE YOUR ESSAY

Note: See http://www.southernct.edu/socialwork/bachelorsprogram/application/for more information on BSW application and acceptance procedures.

Student ID#: Click to enter text

Last Name: Click to enter text

First Name: Click to enter text

M. I. : Click to enter text



Status: ☐Full Time ☐Part Time

Email: Click to enter text.

Cell Phone: Click to enter text.

Home Phone: Click to enter text.



Permanent Address:

Click to enter STREET ADDRESS.

Click to enter TOWN. Click to enter STATE. Click to enter ZIPCODE


Current Address:

Click to enter STREET ADDRESS.

Click to enter TOWN. Click to enter STATE. Click to enter ZIPCODE



If you transferred credits, you MUST attach a copy of your transcript from each school you transferred from. The transcript(s) MUST have the letter grades for the courses you took from other school. An unofficial transcript will be acceptable.

Did you transfer any credits from other two- or four-year schools? ☐Yes ☐ No

If yes, from where: Click to enter text.


Human Service Experience




List all employment experience and dates:

Click to enter JOB 1.



Click to enter DATES for JOB 1.



Click to enter JOB 2



Click to enter DATES for JOB 2.



Click to enter JOB 3.



Click to enter DATES for JOB 3.



Click to enter JOB 4.



Click to enter DATES for JOB 4.

Click to enter JOB 5.



Click to enter DATES for JOB 5.



List all volunteer experience and dates:

Click to enter VOL 1.



Click to DATES for VOL 1.



Click to enter VOL 2.



Click to enter DATES for VOL 2.



Click to enter VOL 3.



Click to enter DATES for VOL 3.



Click to enter VOL 4.



Click to enter DATES for VOL 4.



Click to enter VOL 5.



Click to enter DATES for VOL 5.





List organizations in which you are an active member.

Community:

Click to enter COMMUNITY orgs.




University:

Click to enter UNIVERSITY orgs.





Personal Essay


The final part of the application is a one to two page essay that you will write in the Lang Social Work House. You can write your essay anytime during business hours, Monday through Friday. Simply ask the secretary or student worker for the BSW application essay and you will be given a place to complete it. Please allow at least one hour to complete the essay. When you are done, please leave this application and your essay in the BSW ADMISSIONS mailbox at Lang house.

Curriculum Map

Please fill out your Curriculum Map and bring it with you to Lang House to submit with your completed application:

http://www.southernct.edu/academics/schools/health/academic-programs/socialwork/bachelorsprogram/Social%20Work%20Curriculum%20Map%202016%20hoffler%20revision_ABS.pdf)

Use Degree Works to confirm completed/in-process courses. Transfer students, be sure to also bring transcripts from EACH two- and four-year college/university you have attended.



Demographic Information

You are under no obligation to reveal your age, gender, or race/ethnicity. The material is for statistical purposes only and will not be used in the admissions process.



Age: Click to enter AGE. Gender: Race/Ethnicity:

APPLICATION SIGNATURE

I hereby certify that the statements presented in this form are true and correct. I realize that any misleading information given by me may be cause for dismissal.

Signature_________________________________________________

Date:

SOUTHERN CONNECTICUT STATE UNIVERSITY

BSW PROGRAM ADMISSION REQUIREMENTS


General Admission Requirements




  1. Admission to the university



  1. Completion of a minimum of 57 credits in university requirements and cognate courses



  1. Minimum grade point average (GPA) of 2.5



  1. Successful completion of Elementary Statistics (MAT 107) and English Composition (ENG 112)



  1. Completion of Introduction to the Helping Professions (SWK 200) with a minimum grade of B



  1. Completion of the BSW program application, including a completed curriculum map, and a written essay to be completed at the Lang Social Work House.


Transfer Student Requirements


Students who plan to apply to both SCSU and the BSW Program for a Fall semester start date may need to complete both admissions processes simultaneously.

For more information contact:

Steven Hoffler, Ph.D., L.C.S.W.

Department of Social Work

Southern Connecticut State University

Lang House, 101 Farnham Avenue

New Haven, CT 06515

BSWadmissions@southernct.edu

(203) 392-6563 (office)



(203) 392-6580 (fax)


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