University of Illinois
Athletic Training Student Aide Volunteer Program Application
DEADLINE TO APPLY:
For fall semester: April 1, for spring semester: November 1
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
School email
Year in School
*
Please Select
Freshman
Sophomore
Junior
Senior
Have you ever been an athletic training/physical therapy aide before?
*
Yes
No
If yes, explain your previous experience.
Are you CPR certified?
*
Yes
No
If you are CPR certified, please upload your CPR card here:
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How many hours a week would you like to work/volunteer?
*
Please Select
0-5
5-10
10-15
15-20
Why are you interested in being an athletic training aide?
*
What qualities would you bring to our sports medicine department?
*
What do you want to learn and/or get out of being athletic training aide?
*
References (optional)
Please upload your resume here.
*
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How did you hear about this athletic training aide position?
*
Initial to agree to: Statement of Compliance & Confidentiality (page 6/7 of handbook)
*
Initial to agree to: Medical Records Statement (page 7 of handbook)
*
Initial to agree to: Communicable Disease Policy (page 8 of handbook)
*
Initial to agree to: Sports Wagering Activities Statement (page 9 of handbook)
*
Initial to agree to: Sports Wagering Activities Statement (page 9 of handbook)
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
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