<p> RAMAPO COLLEGE OF NEW JERSEY SCHOOL OF SOCIAL SCIENCE AND HUMAN SERVICES SOCIAL WORK PROGRAM</p><p>APPLICATION FOR THE SOCIAL WORK PROGRAM</p><p>Date______Ramapo ID #______(you should receive upon acceptance to the college)</p><p>Name______(LAST) (FIRST) (MIDDLE)</p><p>College Mailing Address (if living on campus)</p><p>______(Street) (City) (State) (Zip)</p><p>Home Mailing Address</p><p>______(Street) (City) (State) (Zip)</p><p>College Phone #______Home Phone #______</p><p>Cell Phone # ______</p><p>Email Addresses ______</p><p>Date of Birth ______Race/Ethnicity ______</p><p>Do you have a valid driver's license? What State? ______</p><p>Do you have use of a car while at Ramapo? ______</p><p>Have you been convicted of a felony? ______</p><p>Page 2 Year expected to complete degree: Month______Year ______</p><p>Credits earned to date (not counting this spring semester) ______</p><p>Credits earned to date toward graduation (not counting this spring semester) ____</p><p>Please list all Spring courses in which you are enrolled:</p><p>Please list any courses you plan on taking during the summer:</p><p>*The Social Work Program does not accept transfer courses in lieu of required courses in the professional foundation areas, unless exact equivalence can be demonstrated in a course from another CSWE accredited BSW program.</p><p>Current students: Please attach a copy of your current Ramapo Degree Evaluation and all transcripts to this form.</p><p>Transfer students: Please attach a copy of all of your transcripts from transferring school to this form.</p><p>PAGE 3 Work Experience:</p><p>Please list your work experiences, both paid and volunteer beginning with most recent position. Attach extra sheets if needed.</p><p>ORGANIZATION/EMPLOYER POSITION HELD & DATES PAID OR RESPONSIBILITY VOLUNTEER PAGE 4</p><p>Personal Statement (Please type your essay and attach it to this application)</p><p>Please write an essay discussing why you are interested in social work. Include information about yourself, your interests, background, experiences, limitations, strengths and any other information you think has a bearing on your potential abilities as a professional social worker.</p><p>Reference</p><p>Please obtain a personal or professional reference letter and attach it to this application (see page 5)</p><p>I have read, and agree to abide by the NASW Code of Ethics (See NASW http://www.socialworkers.org/pubs/code/default.asp or the Social Work Student Handbook) </p><p>SIGNATURE OF APPLICANT</p><p>PLEASE RETURN APPLICATION TO: Professor Mitchell Kahn, Social Work Program, School of Social Science And Human Services, Room G140, Ramapo College, Mahwah, NJ 07430 PAGE 5</p><p>Reference Instructions</p><p>Note: Please discuss your knowledge of this person and comment on their character, motivation and potential abilities to be a social worker. Submit this reference on letterhead stationary to the student or to Professor Mitchell Kahn, Ramapo College Social Work Program, School of Social Science And Human Services, 505 Ramapo Valley Road, Mahwah, NJ 07430</p><p>______APPLICANT'S NAME</p>