Field Faculty Liaison definition

Field Faculty Liaison. The SCSU faculty member that teaches the Field Seminar course and provides oversight for the Field Practicum. Field Instructor/Task Supervisor Data Sheet St. Cloud State University Department of Social Work College of Health and Wellness Professions Name: Position/Title: Agency Name: Agency Address: Phone: E-mail: Field Instructor/Task Supervisor Educational Background: BSW ☐ Other Bachelor’s (Specify) ☐ MSW ☐ Other Master’s (Specify) ☐ PhD/DSW ☐ Other (Specify) ☐ Field Instructor/Task Supervisor Professional Background: Number of years in human service: Number of years in this agency: Number of years in above stated position: Other specific training (describe type and amount): Are you licensed as a social worker in the state of Minnesota? LSW ☐ LISW ☐ LGSW ☐ LICSW ☐ License #: Do you hold any other professional license(s)? (Please specify): How many SCSU Master of Social Work (MSW) student interns have you supervised in your role as Field Instructor in the last five years? How many student interns from other majors/schools have you served as the Field Instructor for in the last five years? Field Instructor/Task Supervisor Signature Date Field Agency Information Form St. Cloud State University Department of Social Work College of Health and Wellness Professions Agency: Address: Phone: E-mail: Provide a job description for an MSW social work student 300 or 600 hour field placement (may be provided here or on a separate sheet). Describe the agency mission and services provided. Describe the field application process for a prospective social work student. List any special conditions or qualifications a prospective intern must meet to be accepted for a field placement (e.g., background check, automobile, language fluency, health screening). How often is your agency interested in hosting an intern (every semester, every other year?) Required Field Agency Documents:* Copy of Field Instructor Degree(s) Copy of Current Field Instructor Resume or CV Copy of Field Agency Non-Discrimination Policy N/A – Documents provided to Social Work Dept. within Past Two Years *email documents to xxxxxxxxxx@xxxxxxxxxxxx.xxx Field Instructor/Task Supervisor Signature Date Student Internship Agreement St. Cloud State University Department of Social Work College of Health and Wellness Professions This contract establishes a relationship between the field agency, the student named below, and the University, for the purposes outlined in the MSW Field Manual. By signing this contract, ...
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Examples of Field Faculty Liaison in a sentence

  • If unsure how to dress in a particular setting or for a particular event, ask your Field Instructor, Field Faculty Liaison, or Field Director and err on the side of modesty.

Related to Field Faculty Liaison

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