Human Services Placement Application

Students enrolled in HMSV 2990 (formerly HSV 2890) should complete and submit the information below upon registering for the course.
Can you pass a background check?   Many organizations require you to pass a background check to complete complete practicum hours at their site. In order to find an appropriate placement for you, please indicate if you can pass a background check or not.

Do you have a current resume? Most placements require a resume and introduction letter. Please send a current resume to Your instructor for the course may also request a copy.

Age Group   Please select all age groups you are willing to work with.
Area of Town   Select all areas of town you would prefer to be placed. These options cannot always be guaranteed but will be taken into consideration.
Are you currently employed at a social service agency?