Student Information
Human Social Services Practicum I
Name _______________________________________________________________
The following information is requested to help us know you better so that we can find the most
useful and satisfying agency for your Practicum I placement. Be assured we will use this
information with the utmost discretion. Please use complete sentences:
1. What are your expectations for Practicum I?
2. How do you hope use this experience in the future?
3. Attach a list of previous work experiences (paid or volunteer) and provide a very brief
description of your job responsibilities and how each experience can contribute to the
4. Please provide personal experiences which you believe will be helpful to you in this
course and placement.
5. Please identify any other knowledge, skills, or past educational experiences which you
believe, will be helpful in this course and placement.
6. Identify your future career goals and explain how you see this practicum experience
relating to them.
7. Identify your current areas of interest in Human Social Services
a. Social Issues
At risk
Criminal Justice
Substance Abuse
Mental Health, Cognitive Disability
Community Resources
b. Populations
Children Teens
Adults Older Adults
Women Men
What about these areas interests you?