University at Albany - School of Social Welfare

APPLICATION FOR ALBANY INTERNSHIPS IN AGING PROJECT

Return completed application and one copy of your resume to: Linda Mertz, Coordinator, Albany Internships in Aging Project, School of Social Welfare, University at Albany, 135 Western Avenue, Albany, NY 12222.

Please type or print information clearly

 

Name:†††††††††† ††††††††††††††††††††††† ††††††††††††††††††††††† ††††††††††† Social Security Number: ††††††††† †††††††††††††††††††††††

 

Mailing Address: ____________________________________________________________†††††††††††††††††††††††

 

City/State/Zip code: __________________________________________________________††† †††††††††††

 

Telephone: ______________________________††††††††††† Email: ___________________________

 

Your current student status:††††††††††† ______ I am applying for the MSW program ( ___ Full time;___ Part time)

††††††††††††††††††††††† ††††††††††† ††††††††††† ______ I am applying for the MSW Advanced Standing Program

††††††††††††††††††††††† ††††††††††† ††††††††††† ______ I am currently in the MSW program ( ___ Full time;___ Part time)

 

When will you be ready to start the second field placement? ††††††††††† Year ______________

 

I am applying for ______IAP only

††††††††††††††††††††††† †† ______IAP plus oncology fellowship

 

Please briefly address the following questions on a separate page (one paragraph per question)

  1. What are your career goals? Where do you see yourself 5 years from now?
  1. Why are you interested in working with older persons?
  1. Discuss the attitudes, experiences, and skills that you will bring to this project.
  1. For those applying for the clinical fellowship in oncology at St. Peterís Hospital, why are you interested in working with oncology patients and their families?

For those entering the advanced or second year of the Albany IAP (usually the 2nd year of the MSW program), please provide us with the name of your first year field instructor or other social work supervisor as a reference.**

††††††††††††††††††††††† ††††††††††††††††††††††† ††††††††††† ††††††††††† ††††††††††††††††††††††† ††††††††††† ††††††††††† ††††††††††††††††††††††† †††††††††††
Name†††††††††††††† ††††††††††††††††††††††† ††††††††††† Position ††††††††††† ††††††††††† ††††††††††† Phone Number

 

** If applying prior to your first year, you can give us your field instructorís name at a later date.

 

To be considered for the Albany Internships in Aging Project, you must be in good standing in the MSW program. (By signing below, you give us permission to contact your reference, access your student file, and share information about your background with project staff and potential field instructors with the Albany Internships in Aging Project.)

 

 

Student Signature: __________________________________††† ††††††††††† Date: ____________________†††††††