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MASTER OF SOCIAL WORK (MSW) ADMISSION APPLICATION
APPLICATION DEADLINE: * FEBRUARY 15, 2015
PLEASE READ CAREFULLY:
Before you apply, you should carefully review the “MSW Application Guidelines” that are posted to our School of Social Work website:
http://www.csulb.edu/colleges/chhs/departments/social-work/master-of-social-work/. Admission to the School of Social Work is contingent
upon admission to the University by Enrollment Services. The University application is a separate process and requires a $55.00 fee. You
will receive a Campus ID# (i.e. Student ID#) from the University after you submit your online application; you must include this Campus
ID# on pages 1 & 2 of this application. Official transcripts must be submitted to University Enrollment Services by February 15.
You must submit a complete application packet to the School of Social Work. All application packets must be complete prior to
submission. The School of Social Work will not process any application that is missing documents. You may either mail your
application packet to the address below or hand-deliver it to our School of Social Work office. Your application materials must be
submitted in an envelope with the following address (whether sent by mail or hand-delivered):
Your First Choice of Program Plan: [“2-YEAR” OR “3-YEAR” OR “ADVANCED STANDING”]
California State University, Long Beach
School of Social Work – Admissions Office
1250 Bellflower Blvd.
Long Beach, CA 90840-4602
* If you mail in your packet, it must be postmarked no later than Sunday, February 15. If you hand-deliver your packet, it must be dropped
off by 5:00 p.m. (PST) on Monday, February 16. Make copies of your application for your records.
APPLICATION CHECKLIST: You must INITIAL EACH of the following items to acknowledge that you have completed each required
step for admission to the University and the School of Social Work:
_____ I have submitted a University Graduate Admission Application online at CSU Mentor: http://www.csumentor.edu.
(IMPORTANT: Apply first to the University, then submit your School of Social Work application packet.)
_____ I have requested that official transcripts from all colleges and universities I have attended be submitted to University Enrollment
Services. (Transcript deadline: February 15, 2015)
_____ I have enclosed the following documents/information in this application packet:
_____ Completed MSW Admission Application (signed & dated)
_____ Grade Point Average calculated on application
_____ Elementary Statistics syllabus enclosed
OR
_____ Elementary Statistics course verified on approved list
_____ Résumé
_____ Personal Statement
_____ Three Reference Forms (see page 7).Letters do not replace Reference Forms. List each reference below and initial each:
1. ___________________________________
2. ___________________________________
3. ___________________________________
PERSONAL INFORMATION:
CSULB 9-digit Campus ID# (required): __________________________________
Date of birth (mm/dd/year):___________________
Last Name: _________________________ First Name: ______________________ Middle Initial: _____ Maiden: _________________
Street Address: ___________________________________________ City: _______________________ State: _____ Zip: _________
Cell Phone #: _________________________ Home Phone #: __________________________ Work Phone #: ____________________
Email Address: ________________________________________________________________________________________________
Gender:
[ ] Male
[ ] Female
Ethnicity:
[ ] African American / Other Black
[ ] American Indian / Native American
[ ] Asian American / Other Asian
Are you a U.S. citizen? [ ] Yes
[ ] Chicano / Mexican-American
[ ] Puerto Rican
[ ] Other Latino(a) / Hispanic
[ ] No
[ ] Pacific Islander / Native Hawaiian
[ ] White / Caucasian
[ ] Multiple Race / Ethnicity
[ ] Other (specify below):
________________________
[ ] Decline to State
If no, do you have Permanent Residence status? [ ] Yes ** [ ] No
**Note: If you are applying as an international student and do not have Permanent Resident status, you must contact the Center for International
Education at 562-985-5476 or [email protected]. This is a critical step in the admission process. Applicants who possess a Bachelor’s degree
from a college or university where English is not the primary language of instruction must pass the Test of English as a Foreign Language (TOEFL).
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Last name: _________________________ First name: ___________________________ CSULB Campus ID: ____________________
SELECTION OF PROGRAM PLAN:
PROGRAM OPTIONS: The School of Social Work offers the following three program plans to complete the MSW degree at CSULB: 2-Year,
3-Year, and Advanced Standing. Nomination to a selected program plan depends on faculty assessment of applicant files and availability.
Applicants are given three choices: select your choices below using the number 1 as your first choice, 2 as your second choice, and
3 as your third choice (if applicable). Please list your first choice on the outside of your application packet envelope.
[
] 2-YEAR
[
] 3-YEAR
[
] Advanced Standing (*see note below)
*NOTE for Advanced Standing applicants: Advanced Standing applicants must have a minimum cumulative GPA of 3.0 and complete
a Bachelor of Social Work degree within the past five (5) years from a CSWE-accredited program by Spring 2015. You are ineligible for
Advanced Standing consideration without meeting these requirements. In addition, our MSW program offers opportunity for study in one of
three areas of concentration (listed below). Advanced Standing applicants should indicate their ranked preference of concentration below
using the number 1 for first choice, 2 for second choice, and 3 for third choice. Please note that this information is for planningpurposes only, and admitted students are not guaranteed their first or second choice of concentration.
ADVANCED STANDING APPLICANTS:
(please rank concentrations below)
[ ] Adulthood and Aging
[
] Child and Family Wellbeing
[
] Integrated Health
STIPENDS AND SPECIAL PROGRAMS:
Are you interested in any of the following? (check all that apply):
[ ] Pupil Personnel Services Credential (PPSC)
[ ] CalSWEC Public Child Welfare Stipend
[ ] Public Mental Health Stipend programs
[ ] University Consortium of Children & Families (UCCF): Public Child Welfare Stipend
[ ] Geriatric Social Work Education Consortium (GSWEC) Stipend
Note: PPSC & stipend descriptions can be found on the School of Social Work website at: http://www.csulb.edu/socialwork
ACADEMIC RECORD:
List all of your academic work beyond high school in the table below. An official transcript from each institution must be submitted directly
to University Enrollment Services no later than February 15, 2015. You must complete a baccalaureate degree from an accredited college
or university by the end of the spring semester/quarter prior to starting the MSW program.
Name of College or University
Dates Attended
Major
Degree
Were you previously enrolled in another MSW program? [ ] Yes [ ] No
If Yes, you must provide a letter from the Dean/Director of the school previously attended documenting your academic status. You must
also provide a letter from the Director/Coordinator of field education documenting your performance while enrolled in the program.
Are you reapplying to the CSULB MSW program? [ ] Yes [ ] No
If yes, please list the year(s) you applied: ____________________
(Optional) Are you currently applying or planning to apply to other schools of social work? [ ] Yes [ ] No
List schools: ____________________________________________________________________________________________
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GRADE POINT AVERAGE:
The School of Social Work requires a minimum cumulative GPA of 2.5. You must have at least a 2.5 GPA at the time
you apply to our program.
Cumulative GPA: _______________
Number of units: ____________
PRE-REQUISITE COURSE:
An approved course in Elementary Statistics (in any subject area) is a pre-requisite requirement for admission to the MSW program.
The course must be completed by the end of the spring semester/quarter prior to starting the MSW program.
You must earn a grade of “C” or better in the statistics course; a grade of “C minus (C-)“ is not sufficient to meet this requirement.
We have posted a list of approved courses on our website:
http://www.csulb.edu/colleges/chhs/departments/social-work/master-of-social-work/.
If your course is not included on the approved courses list, you must submit a copy of the course syllabus in your application packet.
Please list below the information regarding your Elementary Statistics course:
Course Number: ________________ Course Title: _________________________________________________________________
College/University: __________________________________________ Semester/Year: __________________ # Units: _________
Indicate the status of the course at the time of application:
Is this course included on our list of approved courses? :
[ ] In Progress
[ ] Yes
[ ] Completed
Grade: _____________
[ ] No (a copy of the course syllabus is enclosed)
EXPERIENCE / RÉSUMÉ:
You must include a current résumé in your application packet. List your most recent Social Work or Social Work-related experience
first. Include all paid, internship, and volunteer experience in your résumé. For each position, you must list the following information:
•
•
•
•
•
•
•
Organization / Agency Name and City / State
Type of position: Volunteer / Internship / Paid
Your Title
Start date & End date
Number of hours per week or month [Examples: “25 hours per week”, “15 hours per month”]
Title of immediate supervisor
Detailed description of your duties
Please note that students are not given credit toward degree requirements for life experience.
Are you currently working for one of the following agencies?
[ ] L.A. County Department of Children and Family Services
[ ] Orange County Social Services Agency
[ ] Los Angeles County Department of Public Social Services
[ ] Other public child welfare or social service agency
____________________________________________________
PERSONAL STATEMENT:
You must include a Personal Statement in your application packet. It should be typed, double-spaced, 12 pt. font, 4-6 pages in length
and address the areas of discussion on page 6 of this application. Carefully read and follow the instructions & guidelines provided on page
6. Applicants who wish to be considered for the Advanced Standing program must answer Question #9 in addition to Questions #1-8.
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REFERENCES:
You must include three (3) completed School of Social Work MSW Reference Forms in your application packet (see pages 7-8).
You must complete the top portion (including the signature box) of page 1 of each Reference Form BEFORE you provide the form to your
Reference. You must list the name and information for each reference in the table below.
At least one reference must be from an academic source and at least one must be from a professional source. A reference from your
current supervisor is preferred, especially if social work-related (i.e. work, volunteer, or internship). Personal references from friends,
family, and neighbors are not acceptable.
A letter on official letterhead can be included with a Reference Form, but a letter cannot be submitted in place of a Reference Form.
Forms from other institutions will not be accepted.
The person completing the reference should place the Reference Form in a sealed envelope, sign his/her name across the sealed flap,
and provide it to you for submission in your packet.
**NOTE for Advanced Standing Applicants: In order to be considered for the Advanced Standing program, you must submit Reference
Forms from the following references and indicate the specific reference in the table below:
(1) your field instructor/field supervisor or field liaison or the Director/Coordinator of field education for your BASW/BSW program
(2) your Social Work Academic Advisor or a Social Work (BASW/BSW) professor whose course you completed or are currently taking
(3) a professional reference
ALL APPLICANTS: LIST THE NAME AND INFORMATION FOR YOUR THREE (3) REFERENCES IN THE TABLE BELOW:
Reference #1
Reference #2
Reference #3
Name:
Title:
Institution/Organization:
Phone Number:
Email Address:
Professional [
Type of Reference:
Academic [
**Advanced Standing
ONLY:
Specify Required Reference
(example: “Field Instructor”)
see NOTE above
[
[
[
[
[
]
Professional [
]
] Field Instructor/Field Supervisor
] Field Liaison
] Field Director/Coordinator
] Academic Advisor
] BASW/BSW Professor
Academic [
[
[
[
[
[
]
Professional [
]
] Field Instructor/Field Supervisor
] Field Liaison
] Field Director/Coordinator
] Academic Advisor
] BASW/BSW Professor
Academic [
[
[
[
[
[
]
]
] Field Instructor/Field Supervisor
] Field Liaison
] Field Director/Coordinator
] Academic Advisor
] BASW/BSW Professor
HOW DID YOU LEARN ABOUT THE CSULB SCHOOL OF SOCIAL WORK? (CHECK ALL THAT APPLY)
[ ] CSULB Information Meeting
[ ] School of Social Work Website
[ ] Personal Reference
[ ] Professional/Graduate Student Fair – Location: __________________________
[ ] Presentation at Place of Employment – Location: ________________________
[ ] Other: __________________________________________________________
NOTE: APPLICANT MUST SIGN/DATE ON NEXT PAGE (PAGE 5)
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PLEASE READ THE FOLLOWING IMPORTANT INFORMATION AND SIGN/DATE ON THE SIGNATURE LINE:
The applicant is responsible for assembling the application packet prior to submitting it to the School of Social Work Admissions
Office. The application packet must include the follow ing: pages 1 through 5 of this application, résumé, personal statement,
three (3) School of Social Work MSW Reference Forms in sealed envelopes, and a statistics course syllabus (if the course you
completed was not included on the list of approved courses that is posted to our website). All materials submitted to the School of
Social Work become official University property. Official transcripts must be submitted to University Enrollment Services by February 15,
2015. Incomplete and late applications will not be evaluated.
It is understood that in applying to the CSULB School of Social Work the applicant is aware of the necessary commitment of time,
effort, and finances for the rigors of graduate study and professional social work. The School of Social Work reserves the right, on the
basis of educational or professional judgment, to reject an applicant or to dismiss an admitted student whose academic record or
performance in field instruction does not meet minimum expectations or is not consistent with the accepted standards for professional
behavior.
The School of Social Work determines the field work agencies to which students will be assigned, and the majority of field work
agencies are located in low income, urban areas. If admitted to the MSW program, the student agrees to accept the field work
placement assigned by the field faculty of the School. Once admitted to a particular program plan, students are not allowed to change
plans except with the permission of the Graduate Program Coordinator.
**Please be aware that as Social Workers, we are mandated by law to report incidents of child or older adult abuse.**
Your signature below certifies that you have read and understood the above statements and that all materials you have submitted for
consideration are complete and accurate.
Applicant Signature (original signature required)
Date
California State University, Long Beach provides equal opportunity in education without regard to race, color, national origin, sex, gender, sexual
orientation or disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, and Section
604 of the Vocational Rehabilitation Act of 1973.
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PERSONAL STATEMENT GUIDELINES
The Personal Statement provides you the opportunity to share your qualifications and competencies. Other
factors such as grade point average and social work-related experience are important, but this Personal
Statement will be used to evaluate your critical thinking, creativity, and writing skills, as well as help us
determine your appropriateness for the program and the profession. Failure to follow these guidelines or
address each area of discussion will impact your application.
INSTRUCTIONS: The Personal Statement must be written by you without the use of an editor. It should be
typed, double-spaced, 12 pt. font, and 4-6 pages in length. Your Personal Statement must address each of
the questions and areas of discussion below. (IMPORTANT NOTE: In answering these questions, make
sure not to use names or information that might violate the confidentiality of the individuals you
decide to use in your descriptions.)
1. How did you become interested in social work? Include any personal, academic, organizational,
volunteer and/or paid work experiences that motivated you to choose social work as a profession.
2. What are your career goals and interests? How will an MSW education help you to achieve your
goals?
3. Describe some personal traits and abilities that make you particularly suited for the profession of
social work. What attribute would you most like to strengthen during your graduate education?
4. Discuss how your personal values and experiences have prepared you to meet the ethical
obligation of social workers to practice without discrimination as it relates to client diversity (e.g.
class, culture, ethnicity, gender, religion, disability, and sexual orientation). What are some
experiences that you have had that demonstrate your preparedness to fulfill this ethical obligation?
5. Describe your professional social work activities. If you do not currently work in the social work
field, describe how your work or volunteer experience relates to professional social work activities.
Please be as specific as possible in detailing the similarity to social work activities.
6. The social work profession entails a set of core values, as well as a code of ethics. Recognizing
the dignity and worth of the person, understanding the importance of human relationships, service
and integrity are a few of the social work profession core values, which help to inform the NASW
Code of Ethics. Describe a situation in which you were confronted with a value or ethical conflict.
How did you resolve it?
PLEASE READ: Our MSW program is rigorous and requires a significant commitment of time from
students. Students in the Advanced Standing and 2-Year programs are required to take classes on
Mondays and Fridays during the daytime. During the fall and spring semesters, students in the 3-Year
program are required to take classes on Monday evenings, Wednesday evenings, and Saturdays
during the daytime and may have classes on all three days at some point in the program. During the
summer session, students in the 3-Year program must be available to take classes Monday through
Thursday evenings and Saturdays. In addition, students complete 16 hours per week in field internship
during regular agency hours. The exact schedule is determined by the student and the agency at the
time of placement. Most students complete two full 8-hour days; however, at the discretion of the
agency, some students may be permitted to complete the 16 hours in an alternate schedule of one 8hour day and two 4-hour days. An attempt will be made to accommodate a student’s preference
between the two schedules, but the alternate schedule cannot be guaranteed.
7. Please read the information above and describe your plan to accommodate these class and field
internship requirements and the expected demands of our MSW program.
8. Is there anything else you would like us to know as we consider your application (i.e. academic
challenges, awards, etc.)? Please describe.
9. Advanced Standing Applicants Only: Please explain why you think you are a good fit for the
Advanced Standing (AS) program. In addition to meeting the minimum requirements for the AS
program, what do you believe has prepared you to succeed in this accelerated program?
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MASTER OF SOCIAL WORK REFERENCE FORM
TYPE OF REFERENCE (check one): Academic [ ]
Professional [ ]
PART I: Instructions to the Applicant: You must first complete Part I of this form (including the waiver box) and then provide the
form to your reference with an envelope. The reference must return the completed reference form (both pages) to you in a sealed
envelope with his/her signature across the sealed flap. (The reference may include a letter in addition to this reference form, but a
letter cannot be submitted in place of this reference form.) You must then submit the sealed envelope with your application packet
to the CSULB School of Social Work.
APPLICANT NAME:_____________________________________________ DATE OF REQUEST:___________________
REFERENCE INFORMATION:
Reference Name:___________________________________________
Position/Title:______________________________________
Organization/Agency Name: ________________________________________________________________
Street Address: _________________________________________ City: ________________________ State: ______ Zip: _________
Telephone Number: _____________________________________ Email Address: ________________________________________
NOTE: THE FOLLOWING MUST BE COMPLETED AND SIGNED (WITH ORIGINAL SIGNATURE) BY THE APPLICANT BEFORE FORWARDING
THIS FORM TO THE REFERENCE.
Under the provisions of the Family Educational Rights and Privacy Act of 1974, as amended, the applicant, if admitted and enrolled, will
be entitled to access the information provided on this form unless the applicant waives his/her right to review this reference.
Important (check one): I do [ ] do not [ ] wish to waive my right to review this reference.
In accordance with the Family Educational Rights and Privacy Act of 1974, I give permission to release confidential information for
the purpose of application to the CSULB Master of Social Work Program.
_________________________________________________________________________________
Applicant’s Signature (original signature required)
Date
PART II: Instructions to the Reference: The above-named individual has applied for admission to the Master of Social Work
Program at California State University, Long Beach. Your assessment of the applicant will assist the Admissions Committee. This
form is provided for your convenience. Please complete both pages and place the completed form in a sealed envelope, sign
across the sealed flap, and return the sealed envelope to the applicant for submission to the CSULB School of Social Work.
How long and in what connection have you known the applicant? _______________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
List skills that demonstrate the applicant’s potential in the social work profession:___________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
List areas that need development and/or characteristics that may hinder the applicant’s effectiveness as a social worker:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
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REFERENCE FORM – PART II (CONTINUED)
Please rate the applicant relative to other students or employees whom you have known in the same field in recent years.
Explain as needed in the comments section. Please feel free to make further comments on additional sheets.
1. Below average
2. Average
3. Good
4. Superior
5. Exceptional
Bottom 50 Percent
Top 40 percent
Top 30 percent
Top 20 percent
Top 10 percent
Category
1
2
3
4
5
N
N. Not
Observed
Comments
Your impression of professional competence
Ability to conceptualize, organize and
communicate ideas (verbal and written)
Ability to establish & maintain relationships with:
PEERS
SUPERVISORS
CLIENTS
Concern for and participation in the resolution
of social issues
Awareness of and sensitivity to issues of
ethnicity, gender, age and ability
Effectiveness in working with culturally different
individuals and/or groups
Level of maturity and stability
Motivation for graduate study
OVERALL RECOMMENDATION (CHECK ONE):
[
]
I recommend the applicant without reservation as an excellent prospect.
[
]
I recommend the applicant as a good prospect.
[
]
I have some reservations, but think the applicant should be given a chance to prove him/herself;
Please call me: (
[
]
) ___________________________
I think that the applicant is not suited for the program; please call me: (
Reference’s Signature (original signature required)
) _________________________
Date
Please give this Reference Form to the applicant in a sealed envelope with your signature across the seal. Feel free to
make further comments on additional sheets and attach to this form.
California State University, Long Beach
School of Social Work - Admissions
1250 Bellflower Blvd.
Long Beach, CA 90840-4602
California State University, Long Beach provides equal opportunity in education without regard to race, color, national origin, sex, gender, sexual
orientation or disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972, and Section
604 of the Vocational Rehabilitation Act of 1973.
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