Athletic Training Education

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.