OHIO ATHLETIC TRAINERS’ ASSOCIATION
STUDENT SENATE APPLICATION FORM
* required

Name (Last, First):* ,

Email Address:*
Confirm Email:*

NATA membership # (6 digits)

Date Submitted (mm/dd/yyyy):*

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

School Attended:

Graduation date :* GPA :*

Please list the following activities in chronologic order. Include ONLY Collegiate Level Awards.

Student Activities:
Awards and Honors (list name, award presenter, and date given):

Volunteer activities (list award, role played, and date) :

Involvement in ATEP and other Organizations (list association, membership # , and date) :

Leadership Positions related to AT (list positions, duties, and date) :

Professional meetings attended (list meeting title, role played, and date) :

Essay (may cut & paste or type here) :
Be thorough yet concise. Limit your response to 300 words or less. Please describe why you wish to be a student senator for OATA and GLATA. Include in this response the goals you have for this position.

Attachment of Candidate's List of Awards :
Attachment of Candidate's essay :

Type the text from this image:

Use alphanumeric digits only.