Bachelor of

Social Work
Supplementary application
Bachelor of Social Work supplementary application
PRE- OR POST-APPLICATION REVIEWS ARE NOT POSSIBLE DUE TO THE SHEER VOLUME OF APPLICANTS.

Part I: Identifying information

Please print clearly
Surname

Given names

Mailing address
City/town
Tel. business (

Province
)

Postal code

Tel. home (

Email address
Birth date

If you have been known by previous names please provide:

Did you apply to the School of Social Work last year?

Yes

No

Carleton University Applicant Number: (Nine digit number, starts with 100 or 101)
In your first year do you plan to attend:

Full-time

Part-time

Part II: Education

Give a chronological record of education including high school, college, university. Please indicate the percentage
of diploma/certificate/degree completed. All original transcripts must be sent to Undergraduate Admissions.
Name and location
of institution

Dates of attendance
From (M/Y) to (M/Y)

Completed supplementary
applications must be sent to
the School of Social Work at
the following address:

BSW Admissions
School of Social Work
Carleton University
509 Dunton Tower
1125 Colonel By Drive
Ottawa ON K1S 5B6
Canada

Name of Degree/
Diploma/Certificate awarded

Will the degree/diploma/

certificate be completed
by next fall?

All transcripts must be sent to:

Admission Services
Carleton University
315 Robertson Hall
1125 Colonel By Drive
Ottawa ON K1S 5B6
Canada
15-189 1M 09

Part III: Human service/social change experience

Please provide a chronological record of your relevant human service/social change experience, paid or volunteer. Contact people should be able to confirm and comment on the nature of your work.
Please continue on a separate page if necessary. You must calculate your total hours and grand total hours worked.
Job or title
Organization

Dates worked from (M/Y) to (M/Y)

Contact person
Average hours worked per week

Total hours

Describe your work

Job or title
Organization

Dates worked from (M/Y) to (M/Y)

Contact person
Average hours worked per week

Total hours

Describe your work

Job or title
Organization

Dates worked from (M/Y) to (M/Y)

Contact person
Average hours worked per week

Total hours

Describe your work

Grand total hours

I hereby certify that all statements are correct and complete. I understand that I may have to provide documentation
at some future date to substantiate the information I have provided. I understand that any misrepresentation of
information I have provided may result in the cancellation of my admissions application.

Signature of applicant
Please note that any unsigned applications will be considered incomplete.

Date

Bachelor of
Social Work
Supplementary application
Part IV: Admissions essays

Refer to application form for guidelines.

As part of the admissions application process, please provide a 500-word response to each of the following three
questions/requests. Each response must be no longer than 500 words, with a 12-point font.
You must answer all three of the questions/requests and they must be prepared and written solely by you,
the applicant.
1. How have your life, work and educational experiences contributed to your understanding of yourself and others
in relation to the society in which we live? (You may wish to reflect on various aspects of your identity such as
gender, sexual orientation, economic/class status, life as an Aboriginal person, racial or cultural background,
disabilities or abilities).
2. Identify a social problem that you might want to address as a social worker. Discuss the factors that contribute
to or cause this problem. What role would you like to play in resolving this problem?
3. What interests you in applying to a structural school of social work? How does studying social work at Carleton
fit with your career goals?
The final word tally for the above responses must be no more than 1500 words (3x500).
On the last page of your response statements, you must include the following statement: I, (add your name
here), confirm that the above responses were prepared, and written, solely by me.

Education equity
Self-identification form
Under the principles of educational equity, the school has developed a voluntary self-identification form that
asks applicants to indicate whether they are members of the groups identified within the Mission Statement on Education Equity. The information gathered from this form is used to assess whether we have a diverse applicant pool and
whether our admissions reflect that diversity both within a given year and over a longer period of time.
In light of all of the above, applicants are asked to self-identify if they are members of any of the designated groups
under the schools Mission Statement on Education Equity. This self-disclosure is voluntary and the information will be
held in confidence by the Bachelor of Social Work Admissions Committee. The information provided will be presented
in aggregate form only to assist in monitoring and revising policies and strategies aimed at better recruitment, outreach and admissions of diverse groups of students.
Gender:
I identify as a member of the following communities/designated groups identified under the schools Mission
Statement on Education Equity.
Aboriginal

Racial/visible minority/persons of colour

Economically disadvantaged

Persons with disabilities

LGBTQ (lesbian, gay, bisexual, transgender, queer)

This document is available in a variety of accessible formats upon

request. A request can be made on the Carleton University website at:
carleton.ca/accessibility/request.

Protecting your privacy

At Carleton University, we recognize and respect the importance of

privacy. Personal information that we collect is kept confidential. In
accordance with section 41 of the Freedom of Information and Protection
of Privacy Act, Carleton University will only use the information in its
custody or control in the following circumstances: where the individual
identifies the particular information and consents to its use; for the
purpose for which it was collected or a consistent purpose (i.e. a purpose
which the individual might have reasonably expected).

Bachelor of
Social Work
Supplementary application
Reference form

Please print clearly

To the student: you must submit two reference forms. Give one reference form to a person who can comment on
your educational performance, and one to a person who can comment on your human service experience. When you
receive your reference forms, DO NOT OPEN THEM.
To the referee: this student is applying for admission to Carleton Universitys Bachelor of Social Work program. Please
complete and return this form to the student in a sealed envelope with your signature on the back of the
envelope over the seal. Please type or print.

APPLICANTS NAME
Referees name:
Referees title/position:
How long have you known the applicant?

In what capacity have you known the applicant?

Referees address:
Referees signature ____________________________________Date______________________________________
Please rate the applicant on the following items by circling the appropriate number.
(4 indicates excellent," I indicates poor," DK means don't know)
Awareness of and concern about social issues
Academic potential

DK

Ability to work with others

DK

Ability to be resourceful, creative, original

DK

Capacity to change and openness to learning

DK

Communication skills, both written and verbal

DK

DK

Overall assessment

DK

Rating scales seldom provide a full evaluation of the applicants potential for social work studies.
On a separate sheet of paper, please comment on the applicant's personal qualities and achievements,
keeping in mind the nature of the work performed by social workers.

Protecting your privacy

At Carleton University, we recognize and respect the importance of privacy. Personal information that we collect is kept confidential. In accordance with section
41 of the Freedom of Information and Protection of Privacy Act, Carleton University will only use the information in its custody or control in the following
circumstances: where the individual identifies the particular information and consents to its use; for the purpose for which it was collected or a consistent purpose
(i.e. a purpose which the individual might have reasonably expected).

Bachelor of
Social Work
Supplementary application
Reference form

Please print clearly

To the student: you must submit two reference forms. Give one reference form to a person who can comment on
your educational performance, and one to a person who can comment on your human service experience. When you
receive your reference forms, DO NOT OPEN THEM.
To the referee: this student is applying for admission to Carleton Universitys Bachelor of Social Work program. Please
complete and return this form to the student in a sealed envelope with your signature on the back of the
envelope over the seal. Please type or print.

APPLICANTS NAME
Referees name:
Referees title/position:
How long have you known the applicant?

In what capacity have you known the applicant?

Referees address:
Referees signature ____________________________________Date______________________________________
Please rate the applicant on the following items by circling the appropriate number.
(4 indicates excellent," I indicates poor," DK means don't know)
Awareness of and concern about social issues
Academic potential

DK

Ability to work with others

DK

Ability to be resourceful, creative, original

DK

Capacity to change and openness to learning

DK

Communication skills, both written and verbal

DK

DK

Overall assessment

DK

Rating scales seldom provide a full evaluation of the applicants potential for social work studies.
On a separate sheet of paper, please comment on the applicant's personal qualities and achievements,
keeping in mind the nature of the work performed by social workers.

Protecting your privacy

At Carleton University, we recognize and respect the importance of privacy. Personal information that we collect is kept confidential. In accordance with section
41 of the Freedom of Information and Protection of Privacy Act, Carleton University will only use the information in its custody or control in the following
circumstances: where the individual identifies the particular information and consents to its use; for the purpose for which it was collected or a consistent purpose
(i.e. a purpose which the individual might have reasonably expected).