School Social Work Association of Georgia
Book Scholarship

APPLICATION FORM
Deadline: May 20, 2009

Eligibility: Must be a MSW student at Valdosta State University pursuing the School Social Work emphasis, entering concentration year, and in good academic standing. For more information, please contact Ms. Allison Curington at amcuring@valdosta.edu

Last Name:
First Name:
Middle Initial or Maiden Name:
Email Address:
Mailing Address:
City, State, Zip:
Program Level:

Foundation Student
Concentration Student

Graduate GPA:

School Social Work Track:

Already Completed 600 hour School Practicum Placement
Will be completing 600 hour School Practicum Placement
School Practicum Placement:
Name of Field Instructor:
   

List organizational memberships and any leadership positions you may hold:

In a brief paragraph, discuss your future goals as a school social worker:

If there is anything else that you would like to have considered, please note below:

Thank you! Your application will be carefully considered and applicants will be notified about the award as soon as possible.