SBOC Student Application

North Carolina Shrine Bowl Student Assistant in Athletic Training Application & Selection Process
1. Student must be a rising senior in a public high school (member of the NCHSAA).
2. Student must complete the online application form.
3. Student must obtain three people to submit letters of recommendations (required); one recommendation letter must be from the sponsoring licensed high school athletic trainer. Please submit on this web site: https://form.jotform.com/mkliewer/sboc-student-recommendation
4. Student must complete the essay portion of the online application. (Topic: Why should you be selected as a Shrine Bowl Student Assistant?)
5. Student must submit an official high school transcript through the online application.
6. Considerations are:
-Full time student assistant in athletic training at his/her high school, (# of years)

-Good moral character

-Academic achievement

-Leadership

-General knowledge and taping skills

-Sports Medicine / Athletic Training camp attendance

-CPR / AED certified

Time Line: All application submissions are due by August 31.

Selections: The Shrine Bowl Selection Committee will choose one male and one female student.

Selection Committee:
Miles Kliewer
Ryan Hahner
Michael Guerrero

Submissions Instructions:
1. Complete the online application including the essay and transcript upload.
2. Select 3 people to write a letter of recommendation and share this website address for them to submit it online; remember that one of these letters needs to be from your licensed high school athletic trainer.
https://form.jotform.com/mkliewer/sboc-student-recommendation

If you have any questions, please email---mkliewer@wcpss.net

Shrine Bowl of the Carolinas

Sports Medicine Student Assistant Application Form
Please Print in Ink or Type:
Name

Last NameFirst Name
Middle Initial
Date of Birth:

MonthDayYear
Date
Email:
example@example.com
Home Phone Number:
Mobile Phone Number:
Home Address:
City:
State:
Zip Code:
High School:
Licensed Athletic Trainer (Sponsor):
Office Phone:
Mobile Phone:
Home Phone:
Email:
example@example.com
1. List the sports and years you have worked as a sports medicine student assistant at your high school.
2. List the sports medicine / athletic training related conferences or seminars you have attended & years attended
Are you currently CPR/AED certified: YES or NO If you answered YES please list courses completed, the date, and the sponsoring agency.
Completion Date:

MonthDayYear
Date
Sponsoring Agency (AHA, ARC, etc):
Are you currently CPR/AED certified: YES or NO If you answered YES please list courses completed, the date, and the sponsoring agency.
Completion Date:

MonthDayYear
Date
Sponsoring Agency (AHA, ARC, etc):
Student Signature:

Clear
Date:

MonthDayYear
Date
Sponsoring LAT Signature:

Clear
Date:

MonthDayYear
Date
Parent Signature:

Clear
Date:

MonthDayYear
Date

Why should I be selected as a Shrine Bowl Student Assistant?
Please upload your official transcripts below:

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Please provide the size of the following clothing that you would like. These are based on an Adult Men’s cut.
T-SHIRT SIZE:
POLO SIZE:
SWEATSHIRT/HOODIE SIZE:
WARM-UP/SWEAT SUIT SIZE:
Remember to share this web site with the 3 people you select to submit letters of recommendation.

https://form.jotform.com/mkliewer/sboc-student-recommendation
Should be Empty:

North Carolina Shrine Bowl Student Assistant in Athletic Training Application & Selection Process

Shrine Bowl of the Carolinas

Please Print in Ink or Type: