Microsoft Word - Student Form 2008.doc



534035-54610 Helen Bader School of Social Welfare2020 STUDY ABROAD COURSES IN SOCIAL WORK AND CRIMINAL JUSTICESpanish Immersion in Grecia, Costa Rica - UWinteriM 2020, January 2 – 18, 2019Summer Study Abroad in Linz, Austria - Summer 2020, May 25 - June 05, 2020COURSE DESCRIPTIONS (SOC WRK 297 & 497; CRM JUS 297 & 497)The Costa Rica course is a Spanish language immersion course conducted in Grecia, Costa Rica sponsored by Academia Centroamericana de Espa?ol (ACE). Students live with host-families, have afternoon classes studying Spanish (Beginner, Intermediate or Advanced), and mornings attending lectures, visiting community agencies and exploring Costa Rican culture. Students will explore differences and similarities between Latin America in a variety of areas including culture, religion, politics, governmental role and structure, environmental policies, socio-economic realities, healthcare, education, criminal justice, family structures, poverty, domestic violence, social services and immigration. The Austria course concentrates on social work and criminal justice, with special emphasis placed on the role of integration of differing cultures, especially immigrant groups, into society. In this two week course, students will attend a one-week international conference on social work in Europe and have the opportunity to meet students and faculty from universities throughout the region. Through interdisciplinary dialogue and a blend of classroom and field site visits, students will develop a framework to compare the different styles of community involvement and service in Austria and the US. This undergraduate/graduate elective course allows students to study comparative social work and criminal justice policy and practice through Upper Austria University in Linz, Austria.Both programs will have leisure time activities and cultural outings included. Most evenings will be available for free time to explore the local community. Students can earn 3 undergraduate or graduate credits for these courses. Assignment and expectations are tailored to either undergraduate and graduate students.Interest ApplicationPlease save in a Word file, complete the form, and email to Jeanne Wagner jeannew@uwm.edu. Please indicate the course in which you wish to enroll: FORMCHECKBOX COSTA RICA FORMCHECKBOX AUSTRIA 2) Personal Information for All StudentsNAME: Last: FORMTEXT ?????First: FORMTEXT ?????Middle: FORMTEXT ????? Preferred Name FORMTEXT ?????UWM E-MAIL: FORMTEXT ?????Mobile Phone: FORMTEXT ?????GENDER IDENTITY: Specify FORMTEXT ?????AGE: FORMTEXT ?????3). Academic Status of All StudentsUWM department? FORMCHECKBOX Social Work FORMCHECKBOX Criminal Justice FORMCHECKBOX Other (specify) FORMTEXT ????? FORMCHECKBOX Graduate FORMCHECKBOX Undergraduate? ( FORMCHECKBOX Freshman; FORMCHECKBOX Sophomore; FORMCHECKBOX Junior; FORMCHECKBOX Senior) Grade point average (as of last semester): FORMTEXT ?????Expected date of graduation: FORMTEXT ?????4) Background Information: All students, please provide a response to each.Please describe your professional and volunteer experiences (fields of service, populations served, etc.), any relevant work experience, and your current job. FORMTEXT ?????Have you ever traveled outside of the US before? Where? For what purposes? What did you learn from these travels? (3 – 5 sentences) FORMTEXT ?????What do you hope to gain from your study abroad trip? (3 – 5 sentences) FORMTEXT ?????What do you know about the culture and history of the country you plan to visit? (2 – 3 sentences) FORMTEXT ?????Do you speak any language other than American English? If so, which languages? How fluent are you in these languages (read, basic phrases, read and speak comfortably, etc.)? FORMTEXT ?????For COSTA RICA course onlyHabla Espanol? FORMCHECKBOX Si FORMCHECKBOX No Please rate your own Spanish-speaking ability below (check all that apply): FORMCHECKBOX None FORMCHECKBOX Can understand some spoken Spanish FORMCHECKBOX Can read at a beginning level FORMCHECKBOX Can speak rudimentary Spanish at a beginning level FORMCHECKBOX Can speak beyond a beginning level FORMCHECKBOX Can converse with native Spanish speakers FORMCHECKBOX Can speak Spanish fluently and could get around alone in a Spanish-speaking country5) Accommodation Needs for All Students: a) Ground floor essential: FORMCHECKBOX Yes FORMCHECKBOX Nob) Special diet: FORMCHECKBOX Yes FORMCHECKBOX No (details) FORMTEXT ?????Do you have any disabilities that would prevent you from climbing one flight of stairs and walking for about 20 minutes? FORMCHECKBOX Yes FORMCHECKBOX No (details) FORMTEXT ?????Do you have any allergies that would impact your accommodations? FORMCHECKBOX Yes FORMCHECKBOX No (details) FORMTEXT ?????Are you a smoker? FORMCHECKBOX Yes FORMCHECKBOX No. Are you willing to room with a smoker? FORMCHECKBOX Yes FORMCHECKBOX NoFor AUSTRIA course students only:Do you want to room with a specific student on the course? FORMCHECKBOX Yes FORMCHECKBOX No Please provide name if “Yes.” FORMTEXT ?????For COSTA RICA course students only:I prefer a host family with (check all that apply): FORMCHECKBOX children FORMCHECKBOX without pets FORMCHECKBOX another ACCE student (name FORMTEXT ?????) FORMCHECKBOX an older adult FORMCHECKBOX I have no preference FORMCHECKBOX Other FORMTEXT ?????6) Academic Expectations for All StudentsWithin my preferred concentration (Social Work, Criminal Justice, or other field), I am especially interested in the following topics for my final paper, in order of preference: 1) FORMTEXT ?????2) FORMTEXT ?????3) FORMTEXT ?????7) Do you plan to use credits from this course to fulfill the Trauma Informed Care Certificate? FORMCHECKBOX Yes FORMCHECKBOX NoThis is an interest application only. After review by the faculty of the HBSSW, you will be contacted to confirm your interest. *** In order to be accepted and enroll in a study abroad course, you will need to complete the formal online application for the course through the Center for International Education website.Costa Rica - - TBAPlease email this form to jeannew@uwm.eduDr. Susan J. Rose, PhDInternational Education CoordinatorHelen Bader School of Social WelfareUniversity of Wisconsin-MilwaukeePO Box 786Milwaukee, WI 53201. ................
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