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Department of Kinesiology
Member, Texas Tech University System The Princeton Review - 373 Best Colleges, 2011 Edition

Athletic Training Education Program Application

General Information:

Name: Date of Birth:

Home Address:

City:   State:   Zip:

Home/Cell Number:

High School:

City:   State:   Zip:

Graduation Date:  GPA:   Class Rank:  SAT/ACT:  

Transfer Students Only:

College Attended:

Years Attended:   Major:

Address:

City:   State:   Zip:

Experience:

Athletic Training: Yes No     If yes, then how many years or semesters?

Sports worked with:

Athletic (Played or Managed):

Hobbies/Interests:

School Organizations involved with:
Certifications:
First Aid: Yes No   Expiration:

CPR: Yes No   Expiration:

EMT: Yes No   Expiration:

Other: I have read the technical standards form and will be submitting the application signed by mail:
Yes No

References:
List three names of references, addresses, and phone numbers:
1.
2.
3.