Self-Referrals

A student can independently contact an agency to seek their own placement, including making inquiries to determine if an agency is interested in an intern. If a student prefers this option the Student Self-Referral form must be submitted to the Office of Practicum Education once a student has interviewed with an agency and received confirmation of acceptance. The Office of Practicum Education will contact the agency to ensure the quality of the placement, appropriate learning opportunities, and to establish a clear relationship between SSW and the agency.

After student interviews with a potential agency, student must submit the following form for review and follow up by the Office of Practicum Education. Completion of this form is not an automatic approval of the placement. Overview-of-Practicum-Requirements can be used to have a discussion with your potential Practicum and/or Task Instructor about the roles and responsibilities involved.


You can submit the Self-Referral Form below after you have:

  • Completed the Main Office of Practicum Education application
  • Interviewed and have been accepted at this agency

Click the link below to complete the Self-Referral Form:

StudentĀ Self-Referral Form