Social Work Intern Request Form

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The Columbia High School Social Work Intern Program (SWIP) places graduate school social work interns into South Orange Maplewood's Columbia High School to provide a full range of counseling services for students and their families.

The program's goal is to support students who are experiencing social/emotional challenges and to help those students become more available to the learning process. The program offers a full range of clinical services including: prevention, assessment, parent advocacy and referral services. Counseling is provided in individual and group modalities.

Email *

Student's name and pronoun(s) *

Please type reason for referral below: *

Who is filling out this form? *

School Counselor

Student

Parent/Guardian

Teacher/School staff

Other:

Is student/family aware of referral?

Yes

Clear selection

A copy of your responses will be emailed to the address you provided.

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