<p> Center for Disability Resources – Social Work Field Placement Application</p><p>Please print or type and provide all requested information. Return this form along with your resume to Meghan Trowbridge. Director of Training & Community Development Center for Disability Resources USC/SOM/PEDS Columbia, SC 29208 Phone: 803.935.5634 Fax: 803-935-5059 Email: [email protected]</p><p>Please note that to be considered for an internship, disability specific knowledge is not required; only inquisitive and open minds.</p><p>Date: ______</p><p>Name: ______</p><p>Local Address: ______</p><p>Phone Number: ______</p><p>Email Address: ______</p><p>Overall GPA: ______(undergraduate or graduate)</p><p>Are you applying for: ____ Undergraduate Field Placement ____ Graduate Field Placement</p><p>Area of concentration: ____ BSW ____ MSW ____ MSW/MPH </p><p>Please check appropriate year of field placement: _____ 1st Year ____ 2nd Year</p><p>If you are a 2nd year social work student at USC, are you a macro or micro student? </p><p>If you are a public health student at USC, which academic department are you taking classes from (i.e., Exercise Science, Epidemiology, HSPM, HPEB, etc.)? ______Short Answer Questions 1. What are your personal objectives for this internship?</p><p>2. What specific skills do you hope to develop through your field placement/internship with CDR?</p><p>3. What marketable skills or strengths do you currently possess?</p><p>4. A brief statement of your career goals and an explanation of how you would like this internship to help you reach those goals.</p><p>5. What personal expectations do you have for yourself while interning?</p><p>6. What expectations do you have for the Center for Disability Resources?</p><p>7. If you have any experience with people with disabilities, please share. (NOTE: this is NOT a requirement for field placement at CDR)</p>