BSW Practicum Forms

Please note: students are required to read the BSW Practicum Manual, which is designed to provide students with the essential information for making the practicum a successful experienceClick here for the manual webpage.


  • The Practicum Application is found in SONIA (our practicum tracking software).

► INITIAL FORMS — due before students can begin counting practicum hours. Once students have confirmed a placement the following forms need to be completed via Sonia:

  • Memorandum of Responsibilities Between Agency, Student & School of Social Work
  • Essential Skills Agreement
  • Practicum Proposal for Place of Employment (if needed)
  • Practicum Acknowledgment of Risk Form
  • Request for Block Placement (if needed) [Word]
  • Learning Agreement (in SW 487)

► LEARNING AGREEMENT / PERFORMANCE EVALUATION — due within 3 weeks of beginning practicum

The Learning Agreement / Evaluation form was developed as both a working tool for the student to use at their agency and as a tool for the agency to evaluate student performance.  The Learning Agreement part of the form is completed by the student working with his/her Agency Field Instructor (supervisor at the agency). It is to be submitted to the Practicum Office within three weeks of beginning the practicum experience. The student should retain a copy, provide a copy to his/her Agency Field Instructor, and provide a copy to the Practicum Office. Electronic completion and submission is preferred.

The Agency Field Instructor completes an online evaluation of the student based on goals identified in the learning agreement at the end of each semester.  Links to the evaluation are sent to the Agency Field Instructor.  Evaluations need to be completed prior to the end-of-semester visit.

The monthly timesheet is made available to facilitate tracking practicum hours; students may opt to use their agency's tracking system if one is available.

  • Sample Learning Agreement [PDF]


The Agenda for Weekly Supervision form is a useful communication tool for both the student and the agency to help facilitate weekly meetings and to insure the student is staying on track. 

  • Agenda for Weekly Supervision with Agency Field Instructor [Word - PDF]


Links to these evaluations are sent to the students and Agency Field Instructors at the end of the second semester of practicum.


Practicum students are provided liability/malpractice insurance at no charge. The form below can be provided to your agency should they request proof of insurance.

  • Proof of Liability / Malpractice Insurance [PDF]