University at Albany - School of Social Welfare

Note: This form will be submitted via e-mail. Submitting the form via e-mail will reveal your e-mail address to the recipient and will send the form data without encrypting it for privacy. If you do not wish to send the form via e-mail, please return to the previous page, print the form (click on "print the form"), and mail the form and your updated resume.


Social Security Number

Mailing Address

City/State/Zip code



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 a 1st year MSW program

Full time
Part time

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


What are your career goals? Where do you see yourself 5 years from now?

Why are you interested in working with older persons?

Discuss the attitudes/experiences/skills that you feel you will bring in to this project.

Please paste your updated resume here:

For those entering the advanced or second year of the Albany HIAP (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.



Phone number

To be considered for the Albany Internships in Aging Project, you must be in good standing in the MSW program. By sending this application electronically, 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 Hartford Internships in Aging Project.