DAEMENCOLLEGE - ATHLETIC TRAINING
Professional Phase Application
(Please Print)
Date: ______ First application Reapplication
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Name Last First Middle
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Local Address
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Permanent Address
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Local Phone Cell Number with area code Home Phone
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E-mail address
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Advisor Major as listed on grade reports
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Daemen College Entry date Current Overall GPA (found on program plan)
In order to keep your file current contact the Athletic Training Education Program should any information on this application change after submission.
Athletic Training Clinical Exposure Hours (minimum of 50 hours) – include Log forms from each site
1. DaemenCollege Athletic Training Room Number of Hours
2. Number of Hours
3. Number of Hours
Character references
1. Certified Athletic Trainer Yes No
2. Certified Athletic Trainer Yes No
Biographical Sketch enclosed: Yes No
(Please provide a brief narrative describing your goal/philosophy related to personal, academic, professional and service development, interest in athletic training, and relative background in an allied health profession such as athletic training).
Please initial below indicating that you have received and/or have been informed of the following Athletic Training Education Program policies.
Department of Athletic Training Criteria for Progression to the Professional Athletic Training Program
Athletic Training Professional Phase Academic Standards and Policies / Professional Standards
and Expectations
Participation in Athletic Training Program clinical internships (clinic site specific) may require
criminal background check and/or drug testing.
DAEMENCOLLEGE - ATHLETIC TRAINING
Professional Phase Application
Prior to application to the professional phase all students must complete the Health Care Studies; Health & Fitness Training Concentration and Athletic Training curriculum requirements for years 1, 2, and 3. Please document the prerequisite courses listed below.
Indicate the grade earned for courses already completed and mark an X for course(s) which are in progress.
Daemen Transferred College
ATH 101 Introduction to Athletic Training ______
ATH 201 Seminar in Athletic Training ______
ATH 300 Applied Physics ______
BIO 103/L Human Biology or
BIO 109/L General Biology I ______
BIO 117 Human Nutrition ______
BIO 330/L General Anatomy ______
BIO 340/LGeneral Physiology ______
CHE101/LGeneral Chemistryor
CHE 110/L Chemistry I ______
HCS 200 CPR & Emergency Health Care ______
HCS 301 Physiology of Exercise & Cardiopulmonary
Assessment ______
HCS 317 Human Motion: Principles and Perspectives ______
HCS 332 Strength and Conditioning ______
HCS 340 Musculoskeletal Fitness and Assessment ______
HCS 350 Fitness Training and Exercise Prescription ______
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Applicant Signature Date