Name:

District

Phone:

School:

E-mail:

Year in School for 2011 - 2012:

Student Leadership Conference

May 16-18, 2012

Application Form

What is leadership?

What is volunteerism?

How do you see yourself contributing to the profession of athletic training?

What is the primary reason for you wanting to attend this conference?

What are your goals for the upcoming 2011 - 2012 school year (Student Organization, Academic, Clinical, Etc.)?

What are your career goals following graduation (beyond graduate school)?

NATA Member:

Also due by February 29, 2012:

• Two Letters of Recommendation
  

• Resume
  

Please submit your two letters of recommendation and resume to the Collegiate Sports Medicine Foundation at:

Collegiate Sports Medicine Foundation

PO Box 731

Trumansburg, NY 14886

Attn: Patrick Feely

The Collegiate Sports Medicine Foundation and Cramer Products, Inc. wish your the best of luck with the Student Leadership Workshop as well as in your career as an Athletic Trainer.

District IDistrict IIDistrict IIIDistrict IVDistrict VDistrict VIDistrict VIIDistrict VIIIDistrict IXDistrict X

SophmoreJuniorSeniorEntry Level Graduate Year 1Entry Level Graduate Year 2

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