SELECTED ENTRY APPLICATION FOR INTERNATIONAL STUDENTS MASTER OF APPLIED SOCIAL WORK Applications close: 1 December E rapu kau nei Forever discovering
INTERNATIONAL Student Enrolment form MApplSW 1. Personal details Surname or family name Please comment on the above and any other factors which may be relevant to your ability to undertake this programme of study. First or given name(s) Date of birth Day Month Year Please give details of any health conditions for which you may need support during your study/training. Please answer all questions in this questionnaire on your personal health. While health problems are not usually a barrier to entrance to the programme, it is important for the School to be aware of these, and the School may wish to discuss them more fully with you. Some health problems may make it difficult for you to manage full-time study. Each person is considered on an individual basis. 2. Health declaration (to be completed by the applicant) Name of applicant 3. Referees To help us consider your selected entry application, we require two referees reports to be completed. Signature Please give the report forms and stamped addressed envelopes to two people who are willing to be your referees. Ask them to complete the forms and return them in the envelopes provided. It is best that the referees who have been selected are NOT family members, flatmates or friends. Please fill in your name, contact details and programme choice on each form. Do you have any current or long-term physical or mental health problems? Please give contact details of the people you asked to be your referees. First referee s name Do you require regular or periodic attention from medical/health practitioners? Have you ever been under the care of a psychiatrist/ psychologist/counsellor? Phone number Apart from colds and flus etc, have you had any illness-related episodes requiring medication or other forms of treatment in the last five years? E-mail Second referee s name Phone number E-mail 2
International Selected Entry form MApplSW 4. Academic history If, since leaving school, you have completed, or are currently undertaking, any programme/course of study at a polytechnic, university, or other educational organisation, please: give the details asked for below, and attach verified copies of all qualifications and grades received. Name of tertiary institution Programme of study/qualification Main subject(s) studied Completed 5. Proposed study at Massey University Master of Applied Social Work 6. Method and location of study Albany (Internal) Please tell us why you have chosen this programme, and why you feel you will be good at that type of work. List any personal characteristics you have that might strengthen your application. 7. Employment history If you have had any type of full-time or part-time employment, please give details of this below (this could include voluntary work) or attach a CV. Employer Please give details of any experience you have had in the Social Work field. Experience can include paid or voluntary employment, or any other type of involvement. Position held Type of work involved Dates employed Employer Position held Type of work involved Dates employed 3
International Selected Entry form MApplSW Please describe your reasons for applying for the Master of Applied Social Work. This essay should include: a brief summary of the major events of your life or influences that have led you to consider social work; what you expect from a postgraduate programme of study; and what you plan to do with your qualification after you graduate. If you are changing careers, please explain in detail your reasons for choosing social work as your next career. What fields of practice you have done, and/or would you like to do? Please tell us why you have chosen to consider New Zealand, and Massey University, for your study. If you do not plan to practice in New Zealand, explain how a New Zealand qualification will help you prepare for practice in the country where you will live. If you do not have a B+ average in your undergraduate papers, you should explain why in your essay, and outline your plans to successfully manage a postgraduate academic workload. If you are submitting by hard copy, attach your essay to the information form. Otherwise simply include it in this form. Please include additional pages as necessary. 4
International Selected Entry form MApplSW Fit and proper MASW students: Please note that in order to gain professional registration as a social worker, the following portion of the Social Workers Registration Act 2003 is relevant. The extract below is from Section 47 of the Act. If for any reason you feel that you do not meet these criteria, you are referred to the Social Workers Registration Board s Fit and Proper Person policy, at http://www.swrb.govt.nz/policy. html. You are also required to contact the programme administrator immediately by telephone (06 356 9099 ext 2822) to discuss your situation. Quoted directly from the Act, Section 47 2. For the purposes of subsection (1), the Board may be satisfied that there are grounds on which a reasonable person would conclude that the subject is not a fit and proper person to practise social work if (a) the subject has been convicted, in New Zealand or overseas, of an offence punishable by imprisonment for 3 months or more, and the Board is satisfied that the nature and circumstances of the offence reflect adversely on his or her fitness to practise social work; or (b) the Board is satisfied that the subject is unable to perform adequately the functions required to practise social work satisfactorily; or (c) the Board is satisfied on reasonable grounds that the subject is not of good character and reputation. (3) In the case only of an applicant for registration, the Board may reserve its decision on whether he or she is a fit and proper person to practise social work if it is satisfied (a) that (i) professional disciplinary proceedings are being taken against him or her (whether in New Zealand or overseas); or (ii) a licensing or registration organisation (whether in New Zealand or overseas) is making investigations that may lead to the taking of professional disciplinary proceedings against him or her; or (iii) the Health and Disability Commissioner is making investigations that may lead to the taking of professional disciplinary proceedings against him or her; and (b) that the circumstances suggest a reasonable possibility that he or she is not a fit and proper person to practise social work. Declaration I declare that I have completed the Questionnaire to the best of my knowledge and all information provided on this application to be true and correct, and no information that would have any bearing on this application has been withheld. Signature Day Month Year I have read the above and understand the Fit and Proper requirements. Do you believe you fulfil the criteria for a "fit and proper" person to practice social work in New Zealand? If not, you should explain your circumstances. Please review the explanation of "fit and proper" at: http://www.swrb.govt.nz/policy.html You MUST tick one of these boxes for this form to be accepted for consideration. Have you any convictions which are able to be disclosed under the Criminal Records (Clean Slate) Act 2004? Do you have any criminal charges pending? Failure to declare any convictions may result in course termination. The School of Health & Social Services requires all students accepted into the Master of Social Work programme to be vetted by the Licensing & Vetting Service Centre. If you are successful in gaining a place in the Social Work programme, your form will be forwarded by Massey University to the Licensing & Vetting Service Centre for processing. If your application is unsuccessful, your consent form will be destroyed. Please complete the Consent to Disclosure of Information form included in this selected entry booklet. 5
International Selected Entry form MApplSW Master of Applied Social Work Code 3 8 1 6 Mode: Internal (on campus) Distance Learning (Extramural) Block I E B1 Manawatu Campus (Palmerston rth) Turitea Hokowhitu Albany Campus Auckland Wellington Campus 04 15 10 33 Paper details can be found on our website at http://study.massey.ac.nz. Remember to check that you don t have any exam clashes and that you meet all prerequisite and corequisite requirements. Please indicate which year of papers you would like to enrol in: Semester One Semester Two Summer School Double Semester S1 S2 SS DS I would like to enrol in the following Year One papers Please check http://study.massey.ac.nz for availability, and indicate your preferred semester, location, and mode for each paper. Paper number Semester Location Mode Social and Community Work: Theory and Practice I 179.781 D S Social Policy Analysis 179. 782 D S Māori Development and the Social Services 179. 783 Field Work Practice I 179. 789 D S I would like to enrol in the following Year Two papers Please check http://study.massey.ac.nz for availability, and indicate your preferred semester, location, and mode for each paper. Paper number Semester Location Mode Social and Community Work: Theory and Practice II 179. 784 D S Field Work Practice II 179. 790 D S Management in the Social Sciences 179. 792 Applied Research in Social Work 179. 891 S 1 Research Report - MApplSW 179. 895 D S There is a non-refundable fee charged for each enrolment which remains payable if you later decide to withdraw from all papers. For the latest information, please refer to: http://fees.massey.ac.nz/ 6
First Referee s report MApplSW To assist with selected entry of students to Massey University. This form will remain confidential to members of the selection team. Thank you for acting as a referee for the applicant named below. Your assistance will help us assess the applicant s suitability for their proposed programme of study at Massey University. It would be greatly appreciated if you could fill out this report within 14 days of receiving it from the applicant and send it to us in the addressed envelope. Important: You do not need to answer any question if you: feel you are unable to answer that particular question, or feel uncomfortable answering the question You should complete this report if you have known the applicant for a period of time of one year or more in the capacity of employer, educator or personal character referee. If you are related to the applicant, are a flatmate or are a close friend of the applicant, it would be best if you did NOT complete the report. Thank you again for your help. Applicant s details (to be completed by the applicant) Name of applicant Date of birth Address Telephone Programme of study Location 3816 Master of Applied Social Work Albany Your knowledge of the applicant In your opinion, in what ways do you consider this programme of study is appropriate for this applicant? How long have you known the applicant? What is your relationship to the applicant? (eg teacher, employer, etc) If you are aware of any disabilities/health problems that the applicant has, please say what these are: If you are aware of any criminal convictions, mental health, or issues related to character and reputation of the applicant, please say what these are: 7
First Referee s report MApplSW Applicant s skills/qualities Please indicate your assessment of the applicant s personal qualities, by marking an X in the appropriate place on the scales below: Appreciation of equity issues eg sexism, racism, disabilities, etc excellent poor Honesty outstanding poor Maturity outstanding poor Punctuality outstanding poor Reliability outstanding poor Grooming outstanding poor Tolerance outstanding poor Enthusiasm outstanding poor Acceptance of responsibility outstanding poor Please indicate your assessment of the applicant s interpersonal skills, by marking an X in the appropriate place on the scale below: Relationship with peers excellent poor Relationship with people in authority excellent poor Consideration of others excellent poor Please indicate your assessment of the applicant s communication skills, by marking an X in the appropriate place on the scale below: Reading skills (English) excellent poor Writing skills (English) excellent poor Listening skills excellent poor Spoken language excellent poor Please indicate your assessment of the applicant s attitude to work/study, by marking an X in the appropriate place on the scale below: Perserverance excellent poor Cooperation with others excellent poor Application to work excellent poor Acceptance of help excellent poor Initiative excellent poor Information seeking excellent poor Programme-specific qualities In your own words, please sum up your assessment of the applicant. You may wish to comment on any special skills the applicant has, and your estimation of their suitability for university study, and the programme chosen. Referee s name Phone ( ) Address E-mail Referee's signature Date Once again, thank you for taking the time to complete this report. We value your input into our selection process. Please mail this confidential form directly to: Enrolments, Massey University, Private Bag 11222, Manawatu Mail Centre, Palmerston rth 4442, NEW ZEALAND 8
Second Referee s report MApplSW To assist with selected entry of students to Massey University. This form will remain confidential to members of the selection team. Thank you for acting as a referee for the applicant named below. Your assistance will help us assess the applicant s suitability for their proposed programme of study at Massey University. It would be greatly appreciated if you could fill out this report within 14 days of receiving it from the applicant and send it to us in the addressed envelope. Important: You do not need to answer any question if you: feel you are unable to answer that particular question, or feel uncomfortable answering the question You should complete this report if you have known the applicant for a period of time of one year or more in the capacity of employer, educator or personal character referee. If you are related to the applicant, are a flatmate or are a close friend of the applicant, it would be best if you did NOT complete the report. Thank you again for your help. Applicant s details (to be completed by the applicant) Name of applicant Date of birth Address Telephone Programme of study Location 3816 Master of Applied Social Work Albany Your knowledge of the applicant In your opinion, in what ways do you consider this programme of study is appropriate for this applicant? How long have you known the applicant? What is your relationship to the applicant? (eg teacher, employer, etc) If you are aware of any disabilities/health problems that the applicant has, please say what these are: If you are aware of any criminal convictions, mental health, or issues related to character and reputation of the applicant, please say what these are: 9
Second Referee s report MApplSW Applicant s skills/qualities Please indicate your assessment of the applicant s personal qualities, by marking an X in the appropriate place on the scales below: Appreciation of equity issues eg sexism, racism, disabilities, etc excellent poor Honesty outstanding poor Maturity outstanding poor Punctuality outstanding poor Reliability outstanding poor Grooming outstanding poor Tolerance outstanding poor Enthusiasm outstanding poor Acceptance of responsibility outstanding poor Please indicate your assessment of the applicant s interpersonal skills, by marking an X in the appropriate place on the scale below: Relationship with peers excellent poor Relationship with people in authority excellent poor Consideration of others excellent poor Please indicate your assessment of the applicant s communication skills, by marking an X in the appropriate place on the scale below: Reading skills (English) excellent poor Writing skills (English) excellent poor Listening skills excellent poor Spoken language excellent poor Please indicate your assessment of the applicant s attitude to work/study, by marking an X in the appropriate place on the scale below: Perserverance excellent poor Cooperation with others excellent poor Application to work excellent poor Acceptance of help excellent poor Initiative excellent poor Information seeking excellent poor Programme-specific qualities In your own words, please sum up your assessment of the applicant. You may wish to comment on any special skills the applicant has, and your estimation of their suitability for university study, and the programme chosen. Referee s name Phone ( ) Address E-mail Referee's signature Date Once again, thank you for taking the time to complete this report. We value your input into our selection process. Please mail this confidential form directly to: Enrolments, Massey University, Private Bag 11222, Manawatu Mail Centre, Palmerston rth 4442, NEW ZEALAND 10
Massey declaration I declare that the information given in this form is true and correct, and no information that would have a bearing on my enrolment has been withheld. I understand and agree that: This enrolment form will form part of a contract between me and Massey University. The terms of that contract are set out in the document entitled Student Contract (which can be viewed on the Massey University website). The contract will only be formed, however, when a Confirmation of Enrolment form is issued by Massey University. Information about me may be held by, used by, and disclosed to the following organisations (including their officers and staff) provided it is relevant to their duties: Massey University and wholly-owned subsidiary companies of the University, other tertiary providers with whom Massey University has entered into joint venture or other contractual arrangements, Massey University s Alumni Association, Students Association, Extramural Students Society and related trusts, Ministry of Education, Tertiary Education Commission, StudyLink, Inland Revenue Department, Dept of Work and Income, Ministry of Foreign Affairs and Trade and Specialist Education Services, Tribal trusts and scholarship providers, other tertiary institutions that I am transferring to or from, or with which the University has a conjoint teaching arrangement in which I participate, New Zealand Teachers Council and other professional accreditation agencies where disclosure is permitted or required in accordance with the Privacy Act 1993. My name, date of birth, and residency provided will be included in the National Student Index, and will be used in an Authorised Information Matching programme with the New Zealand Birth Register. For further information, please see: https://nsi.education.govt.nz I have the right to access the personal information which Massey University holds about me and the right to request the correction of that information. Books, journals and other teaching materials made available to me by Massey University are for my own studies, and copying or using them for other purposes is an infringement of copyright. Massey University s Policy on Intellectual Property will apply to my enrolment in research papers or programmes. Security of personal information about me that is held by Massey University is protected by a PIN or other unique identifier provided to me by Massey University. I confirm that the evidence of identity I have provided to the University belongs to me, authorise the use of the unique identifier for admissions and enrolment purposes, accept responsibility for all uses of my unique identifier, and agree not to give my unique identifier to other people. I agree that to the extent permitted at law Massey University s liability to me, howeverso arising, if established, is limited to the amount of tuition fee that I paid for the enrolment period in which liability arises. I authorise the use of my personal information (including photos) for purposes related to my studies and for the provision and improvement of services for students of the University. I solemnly promise to obey the Statutes, Rules and Regulations of Massey University. Signature Date Student name Massey ID number (if known) Please complete the following sections before returning this form My residential address while studying at Massey University will be: Street address Suburb Town/city Postcode Country If your address is not yet known, please tick this box What is your main activity as at 1 October 2011? (eg overseas (regardless of what you are doing), secondary school student, wage or salaried worker, etc) 11
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