Scholars Application

First Name *

Middle Initial

Last Name *

Home Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone with Area Code *

Email Address *

Enter Email Confirm Email

Business Name/Department

Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Phone

Business Email

Enter Email Confirm Email

Are you a Current Employee of Idaho Child and Family Services? *

Yes
No

Select one: *

Master of Social Work degree program at Boise State University’s School of Social Work Child Welfare Program
Master of Social Work Online degree program at Boise State's School of Social Work Child Welfare Program
Bachelor of Social Work degree program at Boise State University’s School of Social Work Child Welfare Program
Bachelor of Social Work degree program at Idaho State University’s Department of Sociology, Social Work, and Criminal Justice
Bachelor of Social Work degree program at Lewis‐Clark State College’s Social Work Program

Letter of References

Provide references from two of the following:

Community agency representative with good knowledge of the applicant
Previous supervisor
Academic advisor or college/university instructor

Current DHW employees must also include a letters of reference from current and next level supervisors.

Reference 1

Reference 1 Name *

First Last

Reference 1 Email *

Enter Email Confirm Email

FERPA Rights for Reference 1 *

The Family Education Rights and Privacy Act of 1974 and its amendments guarantee students access to their educational records. Students may, however, waive their right of access to recommendations. The choice of the applicant regarding this recommendation is to be indicated below. Failure to sign will constitute acceptance of limited access.

I waive my right to review this reference
I retain my right to review this reference

Reference 2

Reference 2 Name *

First Last

Reference 2 Email *

Enter Email Confirm Email

FERPA Rights for Reference 2 *

The Family Education Rights and Privacy Act of 1974 and its amendments guarantee students access to their educational records. Students may, however, waive their right of access to recommendations. The choice of the applicant regarding this recommendation is to be indicated below. Failure to sign will constitute acceptance of limited access.

I waive my right to review this reference
I retain my right to review this reference

References for DHW Employees

This section only applies to applicants who are current employees of Health & Welfare. You must download this PDF form and have your supervisor, followed by your program manager comment fill it out. Completed forms should be emailed to AlyssaReynolds@boisestate.edu.

Supervisor's Name *

First Last

Supervisor's Email *

Enter Email Confirm Email

FERPA Rights for DHW Supervisor *

The Family Education Rights and Privacy Act of 1974 and its amendments guarantee students access to their educational records. Students may, however, waive their right of access to recommendations. The choice of the applicant regarding this recommendation is to be indicated below. Failure to sign will constitute acceptance of limited access.

I waive my right to review this reference
I retain my right to review this reference

Program Manager's Name *

First Last

Program Manager's Email *

Enter Email Confirm Email

FERPA Rights for DHW Program Manager *

The Family Education Rights and Privacy Act of 1974 and its amendments guarantee students access to their educational records. Students may, however, waive their right of access to recommendations. The choice of the applicant regarding this recommendation is to be indicated below. Failure to sign will constitute acceptance of limited access.

I waive my right to review this reference
I retain my right to review this reference

Attachments

Please upload a pdf copy of your acceptance letter from your university or college social work program, if available

You may also email a copy of your acceptance letter to Alyssa Reynolds at alyssareynolds@boisestate.edu.

Accepted file types: pdf, Max. file size: 10 MB.

Write a two page thoughtful essay describing the following:

Why you are applying for an Idaho Child Welfare Scholar Stipend ?
How will receipt of the stipend will enable you to make a professional contribution in a direct service or administrative role within the Child and Family Services?
Incorporate your responses to the six goal areas of the self-evaluation:
1. Leadership
2. Commitment
3. Relationship Capacity
4. Ethics
5. Customer Service

Please upload a pdf copy of the two‐page essay

Accepted file types: pdf, Max. file size: 10 MB.

Agreement : If awarded a stipend, you will be required to sign a contract with the Idaho Department of Health and Welfare, Division of Family and Community Services, Child and Family Services program and no disbursement of stipend can take place until this contract has been signed by all parties. In consideration for a Child Welfare Scholar Stipend Award, there is a corresponding work commitment.

This is a PDF sample copy of a contractual agreement for employees of DHW.

This is a PDF sample copy of a contractual agreement for non-employees of DHW.

Self-Evaluation

The following self-evaluation should communicate:

Demonstrates skills and attitudes important to child welfare services.
Describe yourself in terms of each of the six goal areas listed below.

Please be thoughtful and comprehensive with your goal statement(s).

Leadership: *

We wish to provide financial assistance to social work students committed to providing leadership in public child welfare. This leadership could be in excellent service delivery as a caseworker/clinician, or in training, research, or administration. Please describe how you see yourself in this goal.

Commitment : *

We are seeking to support students who have a commitment to a career in public welfare. Please describe how you see yourself in this goal.

Relationship Capacity : *

We are seeking to support students who have a capacity to build, encourage and maintain positive and professional relationships with colleagues, professional peers and community members. Please describe how you see yourself in this capacity.

Ethics : *

We are seeking to support students who have shown skills of self‐evaluation through appropriate use of supervision and ethical behavior as defined by the National Association of Social Workers Code of Ethics. Please describe how you have accomplished this goal.

Customer Service : *

We are seeking to support students who have shown a capacity for positive, productive service to clients. Please describe how you have demonstrated appropriate empathy and support of client’s efforts through collaboration, advocacy and timely communication.

Address Your Plan

Please address your plan to support public child welfare in your academic pursuit and in your practicum placement. Emphasize ideas that you believe will advance your education and “new learning” in child welfare practice. Please comment on any additional strengths you would like for us to consider, or limitations you have identified in your own ability to complete the program for which this award is being presented. If you have discussed performance or professional goals with your supervisor (employee applicant), or Child Welfare Faculty Field Instructor (non‐employees) please include those in this statement. This statement is critical to your academic planning and we want to thank you in advance for your candid assessment of yourself. *

I have carefully read this application and have answered all the questions completely. I declare my answers and all statements made by me are therein are true and correct. *

I have carefully read this application and have answered all the questions completely. I declare my answers and all statements made by me are therein are true and correct.

Please click the checkbox to agree.

Scholars Application

Letter of References

Reference 1

Reference 2

References for DHW Employees

Attachments

Self-Evaluation

Address Your Plan

School of Social Work