The University of Hong Kong Department of Social Work & Social Administration Social Work Fieldwork Placement Application for Duration Changes in Fieldwork Placement (Please read regulations at the back) Name of Student: UID : Program of Study: (FT/PT BSW/MSW)* Mobile No.: HKU Email Address: Please circle the placement you would like to change the duration period and specify the month and year under the period you will complete the placement advancement deferment ◀ ▶ Year 4 Program Year 1 Year 2 Year 3 Concurrent Summer ▶end of Yr.4 sum. ▶Yr.4 concurrent SOWK4007 BSW FT SOWK4006 final placement 1st placement Concurrent ▶end of Yr.2 sum. Summer ▶Yr.2 concurrent SOWK6231 MSW FT SOWK6225 final placement 1st placement Concurrent Concurrent ▶Yr.3 concurrent ▶end of Yr.3 sum. MSW PT SOWK6225 SOWK6231 1st placement final placement Reason(s) to change the placement duration period: (Advance placement for all students is not encouraged. Only application with strong justification will be considered. Please discuss with your Program Director before the submission.) (Please use separate sheet to state the reasons if needed) Supporting Reference Document / Medical Certificate * Attached: Yes No To be followed I declare the above-mentioned reasons are valid and ready to make up the fieldwork placement as stated above. Signed: (Applicant) Date: ……………………………………………………………………………………………………………………….. (For SWSA Office Use Only) Follow up contact(s) taken: Phone Interview Others ( ) Remarks: Support / Not Support * Recommend/ Not Recommend * Approve / Disapprove * Signature Signature Signature Program Director Director of Field Instruction/ Head of Department Deputy Director of Field Instruction * Please delete as appropriate Regulations on Deferment in Fieldwork Placement The applicant should state clearly the reason(s) for duration changes and attach necessary supporting documents and/or medical certificates with the application;
The University of Hong Kong Department of Social Work & Social Administration Social Work Fieldwork Placement Application for Duration Changes in Fieldwork Placement (Please read regulations at the back) Name of Student: UID : Program of Study: (FT/PT BSW/MSW)* Mobile No.: HKU Email Address: Please circle the placement you would like to change the duration period and specify the month and year under the period you will complete the placement ◀ advancement deferment ▶ Program Year 1 Year 2 Year 3 Year 4 BSW FT Summer ▶Yr.4 concurrent SOWK4006 1st placement Concurrent ▶end of Yr.4 sum. SOWK4007 final placement MSW FT Summer ▶Yr.2 concurrent SOWK6225 1st placement Concurrent ▶end of Yr.2 sum. SOWK6231 final placement MSW PT Concurrent ▶Yr.3 concurrent SOWK6225 1st placement Concurrent ▶end of Yr.3 sum. SOWK6231 final placement Reason(s) to change the placement duration period: (Advance placement for all students is not encouraged. Only application with strong justification will be considered. Please discuss with your Program Director before the submission.) (Please use separate sheet to state the reasons if needed) Supporting Reference Document / Medical Certificate * Attached: Yes No To be followed I declare the above-mentioned reasons are valid and ready to make up the fieldwork placement as stated above. Signed: (Applicant) Date: ……………………………………………………………………………………………………………………….. (For SWSA Office Use Only) Follow up contact(s) taken: Phone Interview Others ( ) Remarks: Support / Not Support * Recommend/ Not Recommend * Approve / Disapprove * Signature Program Director Signature Director of Field Instruction/ Deputy Director of Field Instruction Signature Head of Department * Please delete as appropriate Regulations on Deferment in Fieldwork Placement The applicant should state clearly the reason(s) for duration changes and attach necessary supporting documents and/or medical certificates with the application;
C-03%20application%20for%20duration%20changes%20in%20fieldwork%20placement_2018.docx