SCSCSW Student Membership Application


Please fill in all applicable fields below.

OR... if you prefer, you may download the student membership form, print it, and send a copy to Leigh Bostic along with a check made out to "SCSCSW".

Questions?
Contact Membership Chair, Leigh Bostic
Email: membership@scclinicalsocialwork.org
Phone: (864) 430-0475
Fax: (864) 298-8032 - attn: Leigh Bostic

First Name:
Last Name:
Preferred Email:
Phone:


Education: (Name of university, major, degree, and year of graduation)
 
Field Placement(s) or Other Clinical Training:
List name of organization, dates, and field instructor or supervisor. (Or you may send resumé to Leigh Bostic)


Every member is encouraged to serve on a committee. Please indicate interest(s):
Education Finance Public Relations
Ethics Nominations
Government Affairs Membership


Membership Category:
I wish to receive a $15 discount on membership by accepting all SCSCSW correspondence electronically (email and website).

Total Membership Cost:


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