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Prospective Field Agency Information

Thank you for your interest in becoming a Field Placement Agency for the Department of Social Work and Youth Services at Saginaw Valley State University!

Below you will find the necessary forms to become a Social Work Field Education Authorized Placement Agency and Community Partner. If you have questions about becoming a Community Partner, please click here or call (989) 964-2547. Once you have contacted or submitted completed forms, the Field Department will contact you to schedule an in-person meeting to learn more about you, your agency and to share more information about our program.


Affiliation Agreement

The Affiliation Agreement is the formal contract between your agency and Saginaw Valley State University. This must be completed and signed by an authorized Agency Representative such as the Chief Executive Officer. This may be submitted via mail, fax or email and must have an original signature. Once this is submitted, the University will review the contract and a copy will be mailed to you once all necessary signatures have been obtained.

Affiliation Agreement (27KB)


Agency and Field Instructor Information Forms

The Agency and Field Instructor Information sheets provide the Field Department with necessary identifying information about both the agency and field instructor's qualifications. These forms must be submitted via mail, fax or email. Please note, that the Field Instructor Information Sheet must have a resume or CV attached.

Agency Information Sheet (183KB)

Field Instructor Information Sheet (219KB)


‌‌General Field Documents

Field Manual (890kB)

Scope of Social Work Practice (138KB)


Document Submission Information

Click Here to email and attach completed forms. 

Mailing information:

Saginaw Valley State University
ATTN: Kim S. Johnson, MSW, LMSW, CBIS
7400 Bay Rd.
GN 235
University Center, MI 48710

Fax Number
(989) 964- 4024

Contact Us
(989) 964-7136(989) 964-7136
(989) 964-4626

Department Chair

Michael Heron


HHS 241