OHIO ATHLETIC TRAINERS’ ASSOCIATION
ATHLETIC TRAINER OF THE YEAR AWARD
CANDIDATE BIOGRAPHY SHEET
(Award Biographies will be produced from this information )

Please complete this biography sheet as it pertains to accomplishments from the PAST YEAR (2007) ONLY and submit it by February 1st.   It is important that you only list items that are beyond the scope of your job responsibilities.   As stated in the OATA By-Laws, the Athletic Trainer of the Year qualifications include:

“The nominee has made contributions to the athletes and athletics at the state, district, and/or national level, made contributions/support to the profession of athletic training at the state, district, and/or national level, and should be a well-respected member of his/her community (i.e.: volunteer, civic organizations, church, school).   (Please consult the By-Laws for a more detailed description of the guidelines)".

Name (Last, First): ,

*Email Address:
Confirm Email:

BOC certification # (9 digits)
Ohio License # (ex. AT-XXXXXX)

*Date Submitted (mm/dd/yyyy):

Home Address:
Street:
City:
State Zip Code
Home Phone (xxx-xxx-xxxx):

Primary Place of Employment
Position/Title
Schools covered (if necessary):

Office address:
Street:
City:
State Zip Code

Office phone (xxx-xxx-xxxx):

OATA Service: (Committees, Ad Hoc Committees, volunteer, legislative reception, marketing event, etc.)

GLATA/NATA Service:

Volunteer ATC activity/local committee (not part of your job) :

Clinical/Professional presentation at OATA, GLATA, NATA, or other athletic training/sports medicine
professional program (not part of your job) :

Clinical/Professional presentation on a sports medicine topic related to work:

Presentation to general public (coaches, AD's, etc) relating to the domains of athletic training :

Author/co-author of an article published in a professional journal pertaining to the field of athletic training (not a part of your job):

Author/co-author of an article published in a professional journal pertaining to the field of athletic training as a part of your job:

Author of a newspaper article published pertaining to the field of athletic training (part of your job or not ) :

Coordinator, or on a symposium committee for work :

Special program creation/delivery (specify what the program was and the audiences) :

Other efforts to promote the field of athletic training (NATA month, etc.) :

Volunteer community service (Habitat for Humanity, Boy Scouts, etc.) :

Short letter on your behalf explaining:
Reasons you are deserving, the qualities you possess that make you worth ATOY,
What ATOY means to you

Attachment of Nominee's Letter :

Attachment of Picture:

Type the text from this image:

Use alphanumeric digits only.