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Ph.D. Program Admission

Ph.D. Online Application Form

Personal Information

*Indicates a required field

Please write your legal name in full:

First:*
Middle:
Last:*
Gender:*
Preferred first name (if any):
List any other name(s)which may appear on transcripts being submitted:
Preferred mailing address:*
City:*
State:*
Zip*
Permanent address (if different from the above):
City:
State:
Zip:
Home telephone:* ( ) -
Work telephone: ( ) -
Cell phone: ( ) -
Current e-mail address:*
Confirm e-mail address:*

Please note: E-mail will be our primary mode of communicating with you about the status of your application; please be sure to include an e-mail address which you will be checking regularly. If you have an auto-filter or spam blocker on your email, please be sure to authorize any e-mail address ending in "smith.edu" and "email.smith.edu" so that our message can by-pass your filters.)

Have you applied to the Smith College School for Social Work PhD program in the past? No
Yes - What year?
   
Date of birth:
Are you a citizen of the U.S.? No Yes
If NOT a U.S. citizen, are you a permanent resident? No Yes
If you are a permanent resident, what is your Alien Registration Number?
If you are neither a U.S. citizen nor a permanent resident, of what country are you a citizen?

Optional Information

Your answers are not required for consideration of application.

Dependent child(ren), age(s)/gender(s):
Other dependents:

Smith College seeks students of all racial and ethnic groups. If you wish to identify yourself as a member of a racial or ethnic group, please indicate below. If applicable, you may check more than one box. We invite you to be specific. (Optional information; not required for consideration of application.)

A.) Are you Hispanic or Latina/o? No
Yes, Hispanic or Latina/o (including Spain)

Please describe your background:

B.) Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

American Indian or Alaska Native (including all Original Peoples of the Americas)
Please describe your background:
Are you enrolled? No Yes / Tribal Enrollment Number

Asian (including Indian subcontinent and Philippines)
Please describe your background:

Black or African American
Please describe your background:

Native Hawaiian or Other Pacific Islander (Original Peoples)
Please describe your background:

 White (including Middle Eastern)

Which best describes your background? European
Middle Eastern
Other

Other

Are you fluent in any language other than English?

No Yes, what language(s)

Academic and Professional Training

MSW degree granted by:
Date granted:
Proposed clinical internship will be work-study: No
Yes

Undergraduate college or universities attended

College/university 1:
Number of years attended:
From (mo/year):
To (mo/year):
Major:
Minor:
Degrees and Dates:
College/University 2:
Number of Years Attended:
From (mo/year):
To (mo/year):
Major:
Minor:
Degrees and Dates:

Graduate or Professional

College/University 1:
Number of Years Attended:
From (mo/year):
To (mo/year):
Major:
Minor:
Degrees and Dates:
College/University 2:
Number of Years Attended:
From (mo/year):
To (mo/year):
Major:
Minor:
Degrees and Dates:
College/University 3:
Number of Years Attended:
From (mo/year):
To (mo/year):
Major:
Minor:
Degrees and Dates:
College/University 4:
Number of Years Attended:
From (mo/year):
To (mo/year):
Major:
Minor:
Degrees and Dates:

Other Academic Information

Social work field experience in graduate school (state nature of work, agency, nature of supervision, hours):

Distinctions, honors, awards, or other noteworthy accomplishments

Have you ever been expelled, suspended, or placed on probation by any secondary school or college you have attended, for reason of academic dishonesty or because of an offense that harmed or had the potential to harm others? No Yes

Have you ever been convicted of a criminal offense or are such charges pending against you at this time? No Yes

If you answered “yes” to either of these questions, you must submit a statement of explanation below:

Please note: Because agencies often times ask for a background check, applicants are encouraged to consult with the social work registry board of your state regarding any restrictions to practicing social work should you have a criminal record.

Membership in professional societies, licenses, certificates and other credentials:
How do you plan to finance the period of study for which you are applying? (check all that apply): Graduate loan programs
External scholarship aid
Other loan(s)
Other:
How did you hear about the Smith Ph.D. Program?

Payment Method

Our application fee is $60. Please indicate your method of payment below. You will submit payment information on the next page.

Please note that we will be unable to process your application until payment is received.


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