University Partnership/ Title IV-E Child Welfare Training Program Field Agency Preference Form If accepted into this program, we will do our best to match you with your preferred field agency, according to your interests and distance from your residence during the academic year. Below are several Ohio Children Services Boards that offer field placements. While many students prefer to stay within Summit County, this agency may not be able to provide placements to all of the UPP students. Tl1us, it is important to rate at least 3-5 agencies. Please indicate your level of interest in 1= O= each of tl1e agencies, rating it from Most interest to Least interest ·1 --- Ashland Co CSB-- Stark Co CSB Trumbull Co CSB --- Wayne Co CSB _ Geauga Co CSB _ Summit Co CSB _ County CSB _ Medina Co CSB _ *This page of your application will not be shared with prospective field agencies. Placement 'To By Be Completed Coordinator . . •· . Field Instructor Field Agency .· Address City .. State County Zip Code . . Cell Phone . Other Fax . Educational History . College Attended Degree Received Date of Graduation Dates of Attendance . .
University Partnership/ Title IV-E Child Welfare Training Program Field Agency Preference Form If accepted into this program, we will do our best to match you with your preferred field agency, according to your interests and distance from your residence during the academic year. Below are several Ohio Children Services Boards that offer field placements. While many students prefer to stay within Summit County, this agency may not be able to provide placements to all of the UPP students. Tl1us, it is important to rate at least 3-5 agencies. Please indicate your level of interest in each of tl1e agencies, rating it from 1= Most interest to ·1 O= Least interest Ashland Co CSB-- Stark Co CSB --- Trumbull Co CSB --- Geauga Co CSB _ Summit Co CSB _ Wayne Co CSB _ Medina Co CSB _ County CSB _ *This page of your application will not be shared with prospective field agencies. Placement 'To Be Completed By Coordinator •· . . . Field Agency .· Field Instructor Address City .. . State County Zip Code . Phone . Cell Fax Other . Educational History . College Attended . . Dates of Attendance Degree Received Date of Graduation
UPP%20Application%202018.docx