Understand the historical framework, organizational ...



[pic]University of Pittsburgh - School of Social Work

BASW Second Semester Field Learning Plan Form

Semester II

|BASW Student’s Name: |      |

|Agency Name: |      |

|Agency Address: |      |

| |      |

| |      |

|BASW Field Instructor: |      |

|Field Instructor Phone: |      |

|Field Instructor Fax: |      |

|Field Instructor Email: |      |

| | |

| | |

|Task Supervisor (if applicable): |      |

|Task Supervisor Phone: |      |

|Task Supervisor Email: |      |

Student’s Weekly Field Schedule:

|Mon. |      |Tues. |      |

| |

|All students must engage in a minimum of one hour formal supervision each week. |

Required signatures:

|Student | |Date: | |

|Field Instructor: | |Date: | |

|Task Supervisor (if applicable) | |Date: | |

|BASW Faculty Advisor/Field Liaison: | |Date: | |

Online:

(Revised February 2012)

The BASW student engages in "generalist" practice in field placement. We define GENERALIST PRACTICE as being grounded in the liberal arts and the person and environment construct. To promote human and social well-being, generalist practitioners use a range of prevention and intervention methods in their practice with individuals, families, groups, organizations, and communities. The generalist practitioner identifies with the social work profession and applies ethical principles and critical thinking in practice. Generalist practitioners incorporate diversity in their practice and advocate for human rights and social and economic justice. They recognize, support, and build on the strengths and resiliency of all human beings. They engage in research-informed practice and are proactive in responding to the impact of context of professional practice.

|Guidelines for the BASW Field Learning Plan |

| |

|1. The Field Learning Plan is the educational plan for the term of field placement; each term is graded separately. The competencies for the Field |

|Learning Plan are developed to reflect the standards of the Curriculum Policy Statement of the Council on Social Work Education as well as the |

|curriculum of the Bachelor’s Degree Program of the School of Social Work, University of Pittsburgh. To the best of their ability, Field Instructors|

|are expected to teach students the learning tasks and monitor practice behaviors that address these competencies given the limitations of their |

|respective settings or roles. The Field Learning Plan also serves as a guide for field instruction and supervision meetings. It further creates a |

|basis for the evaluation and narrative that occur at the end of the term. |

| |

|2. Responsibility for the Field Learning Plan is jointly shared by the Student and the Field Instructor. While additional learning tasks may be |

|developed that go beyond the articulated practice behaviors, the Field Learning Plan should reflect the required learning for BASW level and term |

|of field placement. The Student submits the plan by the appropriate due date to the Practicum Lab Instructor. |

| |

|3. Measurement criteria can include, but not limited to the following: cases, journals, written assignments and material of all kind that is |

|reviewed by the field instructor; oral presentations, clinical documentation, proposals, projects, and task group participation. Direct observation|

|(shadowing) of the Student's work is expected. Feedback and evaluative information from other staff involved with the Student's effort should be |

|incorporated into the evaluation criteria. |

| |

|5. The Student's Practicum Lab Instructor / Liaison reviews and approves the Field Learning Plan. It is used as a focus for agency visits as well |

|as for any issues that may require clarification or problem-solving collaboration between the Practicum Lab Instructor / Liaison and the Field |

|Instructor. |

| |

|7. The Field Learning Plan may be modified during the period of field placement to reflect identified learning needs of the Student as well as |

|changes that may occur. Situations such as student absences beyond three days, irregular attendance, inability to complete the required number of |

|hours, change of field instructor or change of field assignment may need to be brought to the immediate attention of and discussed with the |

|Practicum Lab Instructor/ Liaison. |

| |

|9. A copy of the Field Learning Plan is placed in the Student's academic folder. |

BASW Field Learning Plan Semester 2

Competency #1: Identify as a professional social worker and conduct oneself accordingly (EPAS Competency 2.1.1)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

|Student advocates for client access to needed |Student will assess the need for advocacy on behalf of client system. |      | 1st 4 weeks |

|social work services. |Student will implement advocacy strategy. | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues the practice of personal |Student will share with supervisor her/his thoughts and feelings about client |      | 1st 4 weeks |

|reflection and self-correction to assure |interactions. | |Mid Semester |

|continual professional development. |Student will seek feedback from supervisor and other systems. | |End of Semester |

| |Utilizing feedback, student will develop and implement plan for self correction. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues to attend to professional |Student will identify self as a student intern when communicating with staff and |      | 1st 4 weeks |

|roles and boundaries. |clients. | |Mid Semester |

| |Student will engage in assigned tasks appropriate for generalist practice. | |End of Semester |

| |Student will maintain agency and client confidentiality. | | |

| |Student will uphold NASW Code of Ethics, specifically codes as they apply to field| | |

| |education. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues to demonstrate professional |Student will follow agency dress code. |      | 1st 4 weeks |

|demeanor in behavior, appearance, and |Student will treat clients and staff in a respectful and non-judgmental manner. | |Mid Semester |

|communication. |Student will use clear and understandable language when communicating with staff | |End of Semester |

| |and clients. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| |Student will investigate resources that support lifelong learning (ex: NASW |      | 1st 4 weeks |

|Student plans for engagement in lifelong career |chapter events continuing education opportunities, alumni mentoring). | |Mid Semester |

|learning. |Student will develop written lifelong learning plan. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues the use of supervision and |Student will be prepared for supervision. |      | 1st 4 weeks |

|consultation. |Student will seek supervision appropriately outside of formal meeting times. | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency#2: Applies social work ethical principles to guide professional practice (EPAS Competency 2.1.2)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

| |Student will recognize and identify conflict between personal and professional |      | 1st 4 weeks |

|Student continues to recognize and manage |values. | |Mid Semester |

|personal values in a way that allows |Student will act to protect the clients’ interests. | |End of Semester |

|professional values to guide practice. | | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student makes ethical decisions by applying |Student will accurately identify ethical dilemmas. |      | 1st 4 weeks |

|standards of NASW Code of Ethics. |Student will accurately employ specific appropriate Codes for making ethical | |Mid Semester |

| |decisions. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student exhibits the ability to tolerate |In supervision, student will describe examples of his/her ability to tolerate |      | 1st 4 weeks |

|ambiguity in resolving ethical conflicts. |ambiguity in resolving ethical conflicts. | |Mid Semester |

| | | |End of Semester |

|Student applies strategies of ethical reasoning |In consultation with field instructor, student will analyze decision-making |      | 1st 4 weeks |

|to arrive at principled decisions. |strategies in resolving a particular ethical dilemma. | |Mid Semester |

| |Student will apply discussed strategy in resolving dilemma. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency #3: Apply Critical thinking to inform and communicate professional judgments (EPAS Competency 2.1.3)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

|Student distinguishes, appraises, and integrates|Student will seek out and use knowledge of services and resources available in the|      | 1st 4 weeks |

|multiple sources of knowledge including |community for the benefit of the client/client system. | |Mid Semester |

|research-based knowledge and practice wisdom. |Student will demonstrate decision making and implementation strategies for | |End of Semester |

| |practice based on integration of knowledge from multiple sources, including | | |

| |coursework, relevant research and agency resources. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student analyzes models of intervention and |Student will be able to identify various models of intervention relevant to |      | 1st 4 weeks |

|evaluation. |population served by agency. | |Mid Semester |

| |Student will be able to compare and contrast models of intervention. | |End of Semester |

| | | | |

| |Student will demonstrate the ability to evaluate the efficacy of intervention | | |

| |relative to population served. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues to demonstrate effective oral |Student will verbally communicate clearly and effectively with clients and staff. |      | 1st 4 weeks |

|and written communication in working with |Student will be able to clearly and concisely complete progress notes and service | |Mid Semester |

|individuals, families, groups, organizations, |plans. | |End of Semester |

|communities, and colleagues. | | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency#4: Engage Diversity and Difference in practice (EPAS Competency 2.1.4)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

|Student continues to recognize the extent to |Student will be able to identify own personal experience with groups different |      | 1st 4 weeks |

|which a culture’s structures and values may |than s/he. | |Mid Semester |

|oppress, marginalize, alienate, or create, or |Student will be able to candidly discuss the impact of her/his own personal | |End of Semester |

|enhance privilege and power. |experience on client interactions with supervisor. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student evidences the gaining of self-awareness |Student will be able to identify personal values, beliefs and assumptions evoked |      | 1st 4 weeks |

|leading to practice behaviors that reflect |in relation to the demands of the agency setting. | |Mid Semester |

|ability to eliminate influences of personal |With the direction of the field instructor, student will develop appropriate | |End of Semester |

|biases and values in working with diverse |strategies for managing biases effectively in order to practice without | | |

|groups. |discrimination. | | |

| |Student will be able to work with clients of various cultural, ethnic and racial | | |

| |backgrounds and with a variety of problems and value-sensitive issues. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student intervenes and evaluates the efficacy of|Student will be able to implement interventions based on needs, values, and |      | 1st 4 weeks |

|intervention on clients who differ from them in |strengths of diverse client systems. | |Mid Semester |

|terms of race, ethnicity, national origin, |Student will be able to evaluate the effectiveness of interventions implemented, | |End of Semester |

|religious/spiritual beliefs, age, ability, |both throughout the intervention process and at completion. | | |

|sexual orientation, class, and/or gender. | | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student advocates for agency change in policies |Student will assess impact of current agency policy and procedures on diverse |      | 1st 4 weeks |

|and procedures, as indicated, to increase access|populations. | |Mid Semester |

|by diverse populations as they recognize and |Student will design or redesign program’s policies and procedures to increase | |End of Semester |

|communicate their understanding of the |access to and best practices for vulnerable populations. | | |

|importance of difference in shaping life | | | |

|experience. | | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Students evidences that they view themselves as |Student will be able to describe the impact of culturally diverse factors at all |      | 1st 4 weeks |

|learners and engage those with whom they work |system levels (micro, mezzo, and macro). | |Mid Semester |

|with as informants. |Student will demonstrate effective and culturally competent interviewing skills | |End of Semester |

| |Student will identify how agency policies and procedures affect diverse | | |

| |populations eligible for services. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency#5: Advance human rights and social and economic justice (EPAS Competency 2.1.5)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

| |Student will engage in advocacy on behalf of all system levels |      | 1st 4 weeks |

|By understanding the forms and mechanisms of | | |Mid Semester |

|oppression and discrimination, student | | |End of Semester |

|implements advocacy strategy for human rights | | | |

|and social and economic justice at all system | | | |

|levels (micro, mezzo, and macro). | | | |

|Student continues to advocate for human rights |Student will identify underserved needs of population served by agency. |      | 1st 4 weeks |

|and social and economic justice. |Student will develop advocacy strategies to meet these needs at all system levels | |Mid Semester |

| |(micro, mezzo, and macro). | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues to engage in just practice |Student will identify her/his position of privilege and power in relation to |      | 1st 4 weeks |

|that advances social and economic justice. |client system. | |Mid Semester |

| |Student will acknowledge and honor difference between client system and self. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student engages in just practice. |Student will work effectively in diverse organizational environment. |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency #6: Engage in research informed practice and practice informed research (EPAS Competency 2.1.6)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

|Student uses placement/practice experience to |Student will collect and analyze data. |      | 1st 4 weeks |

|inform scientific inquiry and implements |Student will present findings and discuss practice implications at Poster Session.| |Mid Semester |

|research proposal. | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| |Student will evaluate evidence for validity and use in particular practice |      | 1st 4 weeks |

|Student demonstrates the use of research |situation. | |Mid Semester |

|evidence to inform practice. |Student will apply and appraise the efficacy of evidence based practice approach | |End of Semester |

| |implemented. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency #7: Apply knowledge of human behavior and the social environment (EPAS Competency 2.1.7)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

|Student utilizes conceptual framework to inform |Student will apply relevant HBSE theories and perspectives when assessing and |      | 1st 4 weeks |

|processes of assessment, intervention, and |working with assigned clients/client systems. | |Mid Semester |

|evaluation. |Student will evaluate usefulness of various HBSE theories with respect to | |End of Semester |

| |understanding and working with the client population in field. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student describes and utilizes conceptual | Student will be able to identify issues related to transitions over the course of|      | 1st 4 weeks |

|framework to guide |the life cycle. | |Mid Semester |

|bio-psycho-social-spiritual-cultural assessment.|Student will be able to relate social work perspectives and related theories. | |End of Semester |

| |Student will be able to complete comprehensive, culturally sensitive, | | |

| |bio-psycho-social-spiritual assessments on clients and client systems. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| |Student will be able to evaluate environmental impact upon client’s presenting |      | 1st 4 weeks |

|Student has ability to critique and apply |concerns | |Mid Semester |

|knowledge to understand person and environment |Student utilizes eco-systems theory to assess and intervene to address client’s | |End of Semester |

| |presenting concerns | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency #8: Engage in Policy practice to advance social and economic well-being and to deliver effective social work services (EPAS Competency 2.1.8)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

|Including key stakeholders, student analyzes and|Student will build coalition for support and mobilization. |      | 1st 4 weeks |

|formulates advocacy plan for policies that |Student will prepare implementation plan and budget. | |Mid Semester |

|advance social well-being. |Student will develop indicators to monitor progress and evaluates impact. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student collaborates with colleagues and clients|Student will describe services and resources provided by the agency to its client |      | 1st 4 weeks |

|for effective policy action. |systems. | |Mid Semester |

| |Student will identify and work with key stakeholders. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency #9: Respond to contexts that shape practice (EPAS Competency 2.1.9)

|Practice Behaviors |Tasks |Specific Activities (where applicable) |Due Dates |

| |Student will seek out and use knowledge of services and resources available in the|      | 1st 4 weeks |

|Student continuously discovers, appraises and |community for the benefit of the client system. | |Mid Semester |

|attends to the influence of context (locale, |Student will provide feedback in promoting sustainable changes in service delivery| |End of Semester |

|population, scientific, and technological |and practice to improve the quality of social services. | | |

|developments, and emerging societal trends) on | | | |

|service delivery to provide relevant social | | | |

|services. | | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| |Student identifies agency policies and procedures that impact the quality of |      | 1st 4 weeks |

|Student provides leadership in promoting |service delivery. | |Mid Semester |

|sustainable changes in service delivery and |Student generates ideas to improve service delivery and discusses with field | |End of Semester |

|practice to improve the quality of social |instructor as to viability of proposed improvements. | | |

|services | | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

Competency #10: Engage, assess, intervene, and evaluate with individuals, families, groups, organizations and communities (EPAS Competency 2.1.10)

|Practice Behaviors: |Tasks |Specific Activities (where applicable) |Due Dates |

|Engagement | | | |

|Student continues to substantively and |Student will be able to gather relevant data in an organized manner. |      | 1st 4 weeks |

|affectively prepare for action with individuals,|Student will be aware of, and can appropriately utilize, standardized measurement| |Mid Semester |

|families, groups, organizations, and communities|and diagnostic tools. | |End of Semester |

|by gathering, organizing, and interpreting data.|Student will be able to create clinical recommendations to client systems based | | |

| |on information gathered. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues to display empathy and other |Student will be able to “start where the client is”. |      | 1st 4 weeks |

|interpersonal skills to engage clients. |Student will be able to establish rapport with the client system. | |Mid Semester |

| |Student will be able to create and maintain a therapeutic relationship with | |End of Semester |

| |clients. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student continues to develop mutually agreed on |Student, in concert with client system, will be able to develop clear and timely |      | 1st 4 weeks |

|focus of work and desired outcomes with clients.|service goals. | |Mid Semester |

| |Student will be able to develop measurable objectives designed to meet agreed | |End of Semester |

| |upon goals. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Practice Behaviors: |Tasks |Specific Activities (where applicable) |Due Dates |

|Assessment | | | |

|Student further collects, organizes and |Student obtains clients records follow agency policy. |      | 1st 4 weeks |

|interprets data. |Under supervision, student interprets client data as appropriate. | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student assesses client strengths and |Through the interviewing process, the student will identify at least three areas |      | 1st 4 weeks |

|limitations. |of strength. | |Mid Semester |

| |Through the interviewing process, the student will identify at least three areas | |End of Semester |

| |of challenge. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student develops mutually agreed upon |Student, in concert with client system, will be able to develop clear and timely |      | 1st 4 weeks |

|intervention goals and objectives. |service intervention goals. | |Mid Semester |

| |Student will be able to develop measurable objectives designed to meet agreed | |End of Semester |

| |upon goals. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student selects appropriate intervention |Student will be able to select from an array of intervention strategies. |      | 1st 4 weeks |

|strategies to promote goal attainment. |Student will be able to describe selected intervention and discuss why particular| |Mid Semester |

| |strategy has been chosen. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Practice Behaviors: |Tasks |Specific Activities (where applicable) |Due Dates |

|Intervention | | | |

| | | | 1st 4 weeks |

|Student initiates action to achieve |Under supervision, student identifies organizational goals and prepares for |      |Mid Semester |

|organizational goals. |action. | |End of Semester |

|Student helps clients resolve problems. |Using a theoretical framework, student and client work together toward goal |      | 1st 4 weeks |

| |attainment. | |Mid Semester |

| | | |End of Semester |

|Student negotiates, mediates, and advocates for | |      | 1st 4 weeks |

|clients. |Student connects client to appropriate resources and referrals to promote goal | |Mid Semester |

| |attainment. | |End of Semester |

| |Student advocates for needed services for client. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student facilitates transitions and endings. |Student will be able to assess successful goal attainment and plan termination |      | 1st 4 weeks |

| |accordingly. | |Mid Semester |

| |Student will be able to successfully terminate in the helping process. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

|Student implements intervention strategies to |Student will be able to implement and continually assess progress towards goal |      | 1st 4 weeks |

|promote goal attainment that enhance client |attainment. | |Mid Semester |

|capacities. |Student will be able to revise intervention plan accordingly. | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | | | |

|Practice Behaviors: |Tasks |Specific Activities (where applicable) |Due Dates |

|Evaluation | | | |

|Student critically analyzes, monitors, and |Student will be able to continuously evaluate intervention, not only at |      | 1st 4 weeks |

|evaluates intervention. |termination, but throughout process. | |Mid Semester |

| |Student will be able to evaluate results that test the efficacy of interventions | |End of Semester |

| |used and monitor successes, failures, and progress in achieving outcomes. | | |

| |Student will be able to develop future recommendations for favorable outcome | | |

| |strategies for goal attainment. | | |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

| | |      | 1st 4 weeks |

| | | |Mid Semester |

| | | |End of Semester |

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FIELD PLACEMENT TIME SHEET

|Student Name: |      |Field Placement Site: |      |

|Placement (Check one): | |BASW | |MSW |Field Instructor: |      |

| | | |Field Liaison: |      |

|Semester (Check| |Fall | |Spring |

|one): | | | | |

|EXAMPLE |Sept 7-11 |8-3 |9-5 |

Minimum Hours Required: BSW/300 per term

|STUDENT SIGNATURE | |DATE: |      |

|FIELD INSTRUCTOR’S SIGNATURE: | |DATE: |      |

*Students are required to submit a completed time sheet at the end of the term. The signature of the field instructor and the student reflects that the student has met the required hours for the term. If the student needs to clock more hours after the end of the term to achieve the minimum hours required, please note this in the below comments section.

|Comments |      |

| |      |

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Field Education

School of Social Work

University of Pittsburgh

socialwork.pitt.edu/academic-programs/field-education/

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