OHIO ATHLETIC TRAINERS’ ASSOCIATION
STUDENT LEADERSHIP AWARD
LETTER OF RECOMMENDATION

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

Letter of Recommendation (cut & paste):

Attachment of Letter of Recommendation :

Type the text from this image:

Use alphanumeric digits only.