DEPARTMENT OF SOCIAL WORK
SCHOLARSHIP AND FINANCIAL ASSISTANCE AWARD PROGRAMS

Application Form

Rehfeld __________(Please check criteria)

Dobrow__________(Please check criteria)

Both _____________

B.____ PERSONAL DATA:

Name ________________________     Date ________________________

Ball State ID # _____________

Permanent Address_____________________________________________

                               Street Address

____________________________________________________________

City                                       State                                     Zip Code

Phone Number ________________________________________________

                             Area Code     Telephone Number

Current Address_____________________________________________

                               Street Address

____________________________________________________________

City                                       State                                     Zip Code

Phone Number ________________________________________________

                             Area Code     Telephone Number

Birth Date  ___/___/___

C.      EXTRACURRICULAR AND/OR ACTIVITY IN COLLEGE OR COMMUNITY:

Please list all extracurricular and/or civic activity which may be relevant for a Social Work major. Include offices and leadership roles held.

            1.         List and describe your volunteer experience in Social Work. State the number of hours you volunteered per week and the length of the experience (e.g., twice a week for six months) for every volunteer experience you list. If you received either the Dobrow or Rehfeld Award the previous year, please update the history of your volunteer experiences.

            2.         List and describe your work experience in Social Work.

             3.       a.       Briefly describe the social problem(s) which concerns you and what the social work profession has to offer in solving these concerns.

                    b.       What qualities, skills, or personal qualities do you have that would contribute to the solution of this problem? (Use additional sheets of paper, if necessary.)

                         c.         Reasons for entering the social work profession and what you intend to do with your degree in social work. Please be specific.

If you received a Dobrow or Rehfeld funded award last year, you described a pressing social problem that concerns you. Explain how the classes you have taken this calendar year (or seminars you have attended) have added to your perception of that problem and knowledge pertaining to the solution of that problem. (It is not necessary to write an essay on the problem again. Only a brief update is required.)

4.         How do you plan to finance your college education during the next academic year?

DEPARTMENT OF SOCIAL WORK
FINANCIAL ASSISTANCE AND SCHOLARSHIP REFERENCE FORM

The Department of Social Work offers scholarships and financial assistance awards to qualified students. As a reference for this student, please comment about the applicant's scholarship, character and professional promise and any other qualities which distinguish her/him from classmates or co-workers. We are requesting that your comments be typed (or word processed). Please return this form to the student for whom you are writing this reference. Thank you.

Name___________________________          Date ______________________

Signature  _________________________       Title ______________________

Ball State Students:

I give the Department of Social Work permission to request a copy of my transcript from the Registrar's Office for Departmental use.

Name   _________________________

Student ID Number    _________________________

Date     _________________________