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MSW Program Admission

Field Placement Form

Applicants are admitted with the understanding that they will accept the field placement assignments made by the Smith College School for Social Work. Assignments are made on the basis of our understanding of the suitability of learning opportunities offered for each individual and available field placements.

To assist the Field Work Placement Committee in determining the most suitable learning experiences for your first-year field placement, please complete this form.

* Indicates a required field.

Your Personal Information

First name:*
Middle name:
Last name:*
Date of birth:*
Telephone:* ( ) -
Current address:*

Please contact the Office of Admission if your address changes between now and the start of classes in June at (413) 585-7960 or by e-mail at

I can be contacted at the following temporary address: From: To:
Temporary address:
Current e-mail address*:
Confirm e-mail address*:
Applying for: MSW
MSW transfer

Field agencies often request letters of reference from interns. Please check below to authorize us to forward your admission application letters of reference if requested.

I authorize Smith College to release my letters of reference to my field placement agency if requested.

If you are unable to use this form, e-mail us at the Smith College School for Social Work Office of Admission, or call us at (413) 585-7960.