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MSW - On Campus
Field Education
Field Agencies
New Agency Form
New Agency Information - Field Education
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Complete
Previous USC Contact Name
If you have already spoken to someone from the USC School of Social Work about internships, please write their name in the space provided
Agency Overview
Agency Name
Agency Phone
Website
Agency Description
Agency Auspice
- Select -
For-Profit
Non-Profit
Public/Government
Check all that apply.
Hours of Operation
Monday - Friday
Weekend Hours
Evening Hours
Check all that apply.
General Focus of Services
AIDS
Alzheimer's
Cancer
Child Abuse
Child and Family Protective Services
Corrections/Criminal
Dementia
Development Disabilities
Domestic Violence
Emotionally Disturbed Youth
Family Services
Health/Medical
Homelessness
Immigration
Juvenile Justice
Lesbian/Gay/Bisexual/Transgender (LGBT)
Mental Health
Occupational Social Work
Older Adults/Gerontology
School Social Work
Severe Mental Illness
Substance Abuse
Veteran's Services
Are All Agency Facilities ADA Compliant?
Yes
No
If No, Please Explain ADA Limitations
If you have already spoken to someone from the USC School of Social Work about internships, please write their name in the space provided
Agency Address
Street Address
City
Southern California County
- Select -
Not In Southern California
Los Angeles
Ventura
Orange
Riverside
San Bernardino
San Diego
County
State
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Does the Agency Have Multiple Locations?
Yes
No
Agency Contact Person
First Name
Last Name
Email
Office Phone
Mobile