Volunteer Application- Residency and Fellowship Peer Review Committee

Volunteer Application

Applicant Information:

Question Title

* 1. Please enter your contact information:

First and last name

Email Address

Phone Number

Question Title

* 2. Are you currently certified and in good standing with the Board of Certification for the Athletic Trainer (BOC), or equivalent credentialing entity, as well as professional regulatory bodies (no negative practice sanctions)?

Yes

No

Please indicate credentials other than BOC certification

Question Title

* 3. Please provide your NPI number if applicable

Application Questions:
Your answers to the following questions will influence the selection process.

Question Title

* 4. Thoroughly describe how your experiences meet the qualifications and will contribute to the Committee's success.

Question Title

* 5. Describe in depth how you will ensure diversity, equity, and inclusion are integrated into their contributions.

Question Title

* 6. Elaborate on why you are interested in volunteering.

Application Materials:

Question Title

* 7. Please list three references with contact information.

Reference 1

Reference 2

Reference 3

Question Title

* 8. Please upload your CV or resume

PDF, DOC, DOCX, PNG, JPG, JPEG file types only.