Athletic Training Program Application

Transcription

1 Application Students must apply for and be accepted into the (AT Program). This is a secondary application process to that of the University s application. The application deadline for priority consideration is February 1 st. No applications will be accepted after July 1 st. The applications will be reviewed and selected interviews conducted during late February/early March. Official notification of application status will be offered before April 1st. Prior to completing the application for admission to the AT Program an applicant must: Pacific/Academics/Departments-and-Programs/Sport-Sciences/Academics/Degree- Program/BS-Athletic-Training.html Read the AT Program Mission, Goals, and Objectives Read the AT Program Admissions Policies and Procedures The application packet must include: Completed Application College transcripts from ALL colleges attended (unofficial transcripts are acceptable) o A minimum GPA of 2.90 is required o Passing grade in Human Anatomy (w/ lab) and Human Physiology (w/ Lab) is required Completed Health Requirements Document Documentation of current certification in First Aid. Reviewed and signed the AT Program Technical Standards Completed Application Essay Two completed recommendation forms o One must be completed by a Certified Athletic Trainer A minimum of 50 observation hours under the direct supervision of a Certified Athletic Trainer o The observed hours MUST be verified by a Certified Athletic Trainer Completion of at least two semesters (or three quarters) of full-time study at the college level at the time of admission NOTE: The number of applicants to the program may exceed the number that can be admitted; therefore, no assurance can be given that all applicants admitted to the university and successfully completing the application requirements will be admitted to the clinical education component of the. Completion of the degree does not guarantee passage of the certification exam but does prepare the student to sit for the exam. To the best of my knowledge, the information that is provided on this application is true. Signature of Applicant Date Please return application and supporting material to: Department of Health, Exercise, and Sport Sciences University of the Pacific 3601 Pacific Avenue Stockton, CA *Priority consideration given to applications received by February 1 st.

2 I. Personal Information Name: Date: Pacific Student ID#: - - Date of Birth: / / Mailing Address: Cell Phone #: - - Additional Phone #: - - Contact Address: Emergency Contact Information Name: Relationship: Contact Phone #: - - II. Education 1. College/University Name: City: State: Dates Attended: Degree Earned/Expected: Cumulative GPA: 2. College/University Name: City: State: Dates Attended: Degree Earned/Expected: Cumulative GPA: Anticipated Pacific Graduation Date: Semester: Year:

3 III. Athletic Training Experience 1. Were you an athletic training student in High School? Yes No Number of years 2. Were you supervised by a BOC Certified Athletic Trainer? Yes No Number of hours *If yes please give the Certified Athletic Trainer s Name and Certification #? Name: BOC Certification #: 3. Were you an athletic training student at another university or college? Yes No Number of years 4. Were you supervised by a BOC Certified Athletic Trainer? Yes No Number of hours *If yes please give the Certified Athletic Trainer s Name and Certification #? Name: BOC Certification #: Any additional athletic training experience (professional teams, summer internships, physical therapy clinics, or seminars/workshops attended):

4 IV. Coursework Please identify when you completed/will complete the following coursework: General Biology: Course No: Semester/Year: Grade: School: Human Anatomy: Course No: Semester/Year: Grade: School: Human Physiology: Course No: Semester/Year: Grade: School: Care and Prevention Athletic Training (or equivalent): Course No: Semester/Year: Grade: School: First Aid: Course No: Semester/Year: Grade: School: Additional athletic training related coursework: 1. Course Title: Semester/Year: School: Grade: 2. Course Title: Semester/Year: School: Grade: 3. Course Title: Semester/Year: School: Grade:

5 V. Additional Information 1. Are you a student member of the National Athletic Trainers' Association? Yes No 2. Do you expect to make athletic training your primary career choice? Yes No 3. Have you read the Policies and Procedures for Admission into Clinical Education? Yes No 4. Are you CPR certified? Yes No 5. Are you certified in First Aid? Yes No VI. Application Essay Please type a 1-3 page application essay with the following questions included, but not limited to: 1. Other than the definition of prevention, evaluation, treatment, and rehabilitation of athletic injuries, describe your understanding of the profession of athletic training. 2. Why do you want to be in the clinical education program at Pacific? 3. What unique qualities can you bring to our program? 4. Where do you want to be professionally five years after you graduate from our program? 5. How can the clinical education program at Pacific help you achieve your goals?

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7 Applicant Recommendation Form Last Name First Name Middle **This part to be completed by the applicant. Before giving this form to the individual providing this reference please check one box and sign in the space provided in accordance with the Family Education Rights and Privacy Act of I agree to waive my right to read this recommendation form I do not agree to waive my right to read this recommendation form If you are a current University of the Pacific student: For your recommendation by a Certified Athletic Trainer, please choose a current Athletic Training student and one current Certified Athletic Trainer. This choice of reference should be an individual that you have spent sufficient observation time with, and can adequately fill out a recommendation form on your behalf. Please notify the Athletic Training Student and Certified Athletic Trainer of your choice and ask if they might be willing to complete the recommendation form together. Please give the recommendation form to the Certified Athletic Trainer for completion. Signature of Applicant: Date: This part to be completed by the recommender: Your, two, letters of recommendation play an important role in our selection process, and we greatly appreciate your thoughtful and honest appraisal of the applicant. Pacific s ATEP is particularly interested in an evaluation of the applicant s potential for academic and professional achievement in the field of athletic training. If you do not know the applicant well enough to complete the following form, please return it to the applicant. After completing this form, please place it in a sealed envelope, sign across the seal, and either return to the student to include in their application package or submit to: Christopher Ludwig, EdD, ATC Director - Department of Health, Exercise, and Sport Sciences University of the Pacific 3601 Pacific Ave. Stockton, CA 95211

8 RECOMMENDATION FORM (1) I. Please rate the applicant on the qualities listed below using the following rating scale (please mark appropriate box): 1 = Lower 50% (below average), 2 = in the 50% (average), 3 = upper 25% (above average), 4 = upper 15% (outstanding), 5 = upper 5% (exceptional), N/A = no basis for judgment 5 Exceptional 4 Outstanding 3 Above Average 2 Average 1 Below Average Ability to communicate effectively (oral, include poise) Ability to communicate effectively (written, include clarity, concise) Ability to work with others (interpersonal skills, cooperation) Evidence of psychological maturity and stability Ability to accept criticism and grow with life experience Recognizes own strengths and weaknesses Interest in and knowledge of athletic training Potential for success in the field of athletic training Potential as a leader Reliability to complete assignments accurately and on time Cultural and community interest, involvement, and development Breadth of general knowledge, intellectual ability, logical thinking Interest in independent inquiry, ingenuity, originality, imagination Personal qualities (sincerity, enthusiasm, patience) Displays initiative (seeks knowledge, self directed) Displays flexibility Display problem solving N/A

9 II. Please indicate your attitude toward having this applicant in a responsible position under your direction. Definitely would want her/him Would want her/him Would be satisfied to have her/him Would prefer not to have her/him Definitely would not want her/him Unable to judge III. To your knowledge has there ever been any disciplinary action involving this applicant, which might indicate unsuitability for athletic training? (If yes, please provide full explanation in general comments) Yes No IV. How long have you known the applicant and in what capacity? V. Please check one of the following: I strongly recommend this applicant for the. I recommend this applicant for the. I recommend with reservations this applicant for the. I do not recommend this applicant for the VI. Additional Comments Regarding Applicant: Applicant s First Name (Please print) Last Name Signature Date Recommender s First Name (Please print) Last Name Signature Date Position/Title: Organization: Phone:

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11 Applicant Recommendation Form Last Name First Name Middle **This part to be completed by the applicant. Before giving this form to the individual providing this reference please check one box and sign in the space provided in accordance with the Family Education Rights and Privacy Act of I agree to waive my right to read this recommendation form I do not agree to waive my right to read this recommendation form If you are a current University of the Pacific student: For your recommendation by a Certified Athletic Trainer, please choose one current Athletic Training student and one current Certified Athletic Trainer. This choice of reference should be an individual that you have spent sufficient observation time with, and can adequately fill out a recommendation form on your behalf. Please notify the Athletic Training Student and Certified Athletic Trainer of your choice and ask if they might be willing to complete the recommendation form together. Please give the recommendation form to the Certified Athletic Trainer for completion. Signature of Applicant: Date: This part to be completed by the recommender: Your, two, letters of recommendation play an important role in our selection process, and we greatly appreciate your thoughtful and honest appraisal of the applicant. Pacific s ATEP is particularly interested in an evaluation of the applicant s potential for academic and professional achievement in the field of athletic training. If you do not know the applicant well enough to complete the following form, please return it to the applicant. After completing this form, please place it in a sealed envelope, sign across the seal, and either return to the student to include in their application package or submit to: Christopher Ludwig, EdD, ATC Director - Department of Health, Exercise, and Sport Sciences University of the Pacific 3601 Pacific Ave. Stockton, CA 95211

12 RECOMMENDATION FORM (2) I. Please rate the applicant on the qualities listed below using the following rating scale (please mark appropriate box): 1 = Lower 50% (below average), 2 = in the 50% (average), 3 = upper 25% (above average), 4 = upper 15% (outstanding), 5 = upper 5% (exceptional), N/A = no basis for judgment 5 Exceptional 4 Outstanding 3 Above Average 2 Average 1 Below Average Ability to communicate effectively (oral, include poise) Ability to communicate effectively (written, include clarity, concise) Ability to work with others (interpersonal skills, cooperation) Evidence of psychological maturity and stability Ability to accept criticism and grow with life experience Recognizes own strengths and weaknesses Interest in and knowledge of athletic training Potential for success in the field of athletic training Potential as a leader Reliability to complete assignments accurately and on time Cultural and community interest, involvement, and development Breadth of general knowledge, intellectual ability, logical thinking Interest in independent inquiry, ingenuity, originality, imagination Personal qualities (sincerity, enthusiasm, patience) Displays initiative (seeks knowledge, self directed) Displays flexibility Display problem solving N/A

13 II. Please indicate your attitude toward having this applicant in a responsible position under your direction. Definitely would want her/him Would want her/him Would be satisfied to have her/him Would prefer not to have her/him Definitely would not want her/him Unable to judge III. To your knowledge has there ever been any disciplinary action involving this applicant, which might indicate unsuitability for athletic training? (If yes, please provide full explanation in general comments) Yes No IV. How long have you known the applicant and in what capacity? V. Please check one of the following: I strongly recommend this applicant for the. I recommend this applicant for the. I recommend with reservations this applicant for the. I do not recommend this applicant for the VI. Additional Comments Regarding Applicant: Applicant s First Name (Please print) Last Name Signature Date Recommender s First Name (Please print) Last Name Signature Date Position/Title: Organization: Phone: