ProfessionalUndergraduateAthleticTrainingStudentScholarshipAward

ApplicationNominationPacket

***PleaseNote***

APPLICATIONDEADLINE

st

NominationsmustbereceivedbyApril 1!

OnlyPATSInc.Licensed/Certifiedand Licensed/Certified-RetiredMembers maynominateathletic trainingstudents

SendcompletedNominationPacketand applicablematerialsto:

PATS, Inc. Honors and Awards Committee C/O John Post, MBA, LAT, ATC (Co-Chair) Eastern University

1300 Eagle Road St. Davids, PA 19087

Phone(610)341-1316fax (610) 341-1317

INTRODUCTION:

ThePennsylvania AthleticTrainers'Society,Inc. is acceptingapplications to honorthe outstandingstudents from themembership ofPATS,Inc.Thesescholarships will be awarded to students whohavedemonstrated success academicallyand excelled as athletictrainingstudentsat their institutions. PATS,Inc.will present five awards ($2,000.00 each) to deservingstudents. Thescholarship is meant to encouragethe recipient to pursuetheir education in athletic trainingorarelated field.

Any Licensed/Certified orLicensed/Certified-Retired member of PATS,Inc. is to nominate no morethan one candidateforthis award. Additionally, no more than two candidates can benominated from anyoneinstitution. ThePATS,Inc. Licensed/Certified orLicensed/Certified-Retiredmember is responsible for establishingthe candidate’s eligibility.

All materials areto be completed (forms typed)and forwarded in onepackageto the Chair ofthe PATS,Inc. Honors and AwardsCommitteeat the addresslisted on the cover of this packet.This is the responsibility ofthe applicant.

In the spirit of these awards, previous winners maynot applyfor asecond scholarship. However, candidates that applied anddid not earn ascholarship in a previousyear mayreapplyin a subsequentyear iftheyhave eligibilityremaining.

ThePATS,Inc. Honorsand Awards Committeewill evaluatethe candidate’s applications, conduct formalinterviews ofthe qualified candidates (at the convention), and announceits selections to the membership at thePATS,Inc. annual meetingin May/June.

CRITERIAFORTHESTUDENTSCHOLARSHIPS

To beeligibleforconsideration foraPATS,Inc.Scholarship, an applicantshall:

-have been astudentmemberofPATS fora minimumofsix months priorto the application deadline.

-currentlybe enrolled in a CAATE approved/accreditedcurriculumora programinCAATE candidacywithin the Commonwealth.

-signifyan intention topursue the profession of athletic trainingas a means oflivelihood

-distinguish oneselfthrough service initiatives,clinicalandacademic performance, andexcelas an athletic trainingstudentattheirinstitution. The emphasis oftheseawards is student

involvementoutside of theclassroom(above and beyond required experiences).

-performwith distinctionas a memberofthe AthleticTrainingStudentProgramattheir institution.

-conductoneselfinamannerwhichhasbroughtcredittothemselves,theirinstitution,and/or

intercollegiate athleticsandhighereducation.

NOMINATINGINSTRUCTIONS

PATS,INC.UNDERGRADUATESCHOLARSHIPAWARD

1.Nominations shall berestricted to student members of PATS,Inc.

2.There are fourforms to be completed andreturned:

a.Student applicationcompleted and signedbythe candidate.

b.Evaluation form to be completed andsigned bythe nominatingathletictrainer.

c.Endorsement to be completed and signed byanacademicprofessor.

d.Endorsement tobe completed and signed bythe CollegeDean,Department Chair or individual responsible for thenominee's academicprogram.

3.Pleaseincludethe followingwith each application:

a.Official CollegeTranscript

b.Scores or CollegeEntranceExams, (GRE'sand/orMAT's) if available

c.Copies of all applicablemembership cards(PATS,Inc.,NATA, etc.)Applicants must beamember ofPATS at least 6 months

d.Resume (indicatinghonors, awards, voluntaryservice, experience, certifications, memberships, etc.)

4.TheApplicant is responsible for collectingall materials and forwarding them to theChairpersonof thePATS,Inc. Honorsand Awards Committee.

****CompletednominationpacketsmustbereceivedbytheHonorsAwardsCommittee

st

byApril1st.AnyapplicationpacketsreceivedaftertheApril1

deadlinemaybereturnedto

theapplicantatthediscretionoftheHonorsandAwardsCommitteeChairperson.

THEPENNSYLVANIAATHLETIC TRAINERS'SOCIETY,INC. STUDENTSCHOLARSHIP AWARD

STUDENT'S APPLICATION

(Please type allinformation)

Name: Last,First, Middle

Date of Birth:,

Collegeor University:

Current Class/Year: (Jr,Sr, etc)

Graduation Date:

School Address: Street, City, State,Zip

School Phone:

Permanent Address: Street, City, State,Zip

HomePhone:

Cell Phone:

Email Address(es):

Overall GradePoint Averageon 4.00 Scale after fall semester ofcurrentyear: SAT/ GRE:

Howlonghaveyou beenamember ofthePATS, Inc.?Year:

TheNATA?

Pleaseprovideyour NPInumber:

Doyou plan on pursuinga career within thefieldof athletictraining?

Signatureof Applicant: _

Date:

STUDENT'S APPLICATION (CONTINUED)ACTIVITYPARTICIPATION

Organization/Activity

Leadership Position/Role Awards/Recognition

School or Class Offices:

Other (Civic, Religious,etc.)

ACADEMIC AWARDS

Honors Awarded byyourSchool orInstitution:

ATHLETIC TRAININGSTUDENT ACTIVITIES

List duties other than normal work related dutiesyou performed that arerelated to athletictraining:(Suchas EMT, emergencyroomvolunteer, workshops andseminars attended, youthleague volunteer, etc.)

ATHLETICTRAININGSTUDENTCLINICALEXPERIENCEandESSAY

** Pleaselimit your answerto ONE pageorless– double spaced, 10 font

Pleasewrite anessayaboutyourself.Describehowyou becameinterestedin athletictraining. Provide us with details onyour most significant clinical experiences.Inaddition, pleasetell us aboutyourprofessionalgoal(s) as it/they relate(s) to the athletictrainingprofession.

THEPENNSYLVANIAATHLETIC TRAINERS'SOCIETY,INC. PATS STUDENTSCHOLARSHIP PROGRAM

COLLEGEDEAN,DEPARTMENTCHAIR,PROGRAM DIRECTOR OR ACADEMICIAN

Nominee'sName:

(Last)(First)(Middle)

Institution:

Class/Year:

ACADEMICPROGRESS

DegreeProgram:

Major: Minor:

Certifications, etc.:

Hoursrequiredforgraduation:

Hourscompletedtowardgraduation:

Expected Completion Date:

CumulativeGradePoint Average at CertifyingInstitution:

G.P.A. for AthleticTrainingCourses:

(Based on4.00Maximum)

TESTSCORES:

SAT: VerbalMath

Total

ACT: Composite

National Merit:

GRE: VerbalQuantitativeAnalytical

MillerAnalogyTest:

Signature:

Dean,Chair,orProgramDirector

PrintName:

Date:

THEPENNSYLVANIAATHLETICTRAINERS'SOCIETY,INC. PATS STUDENT SCHOLARSHIPPROGRAM

ACADEMICPROFESSOR RECOMMENDATIONFORM

This form is to be completed bya faculty memberof thenominee’s institution who is not associated with theathletic training program.

Please comment on thenominee'sabilityto pursue advanced studyin athletictrainingor arelatedfield:

Is thereanythingwhichmight impedethis individual'sabilityto pursue athletic training as aprofession? If"Yes", please explain:

This evaluation is basedupon the followingcriteria:

Student’s performanceinthe followingCLASS: Howlongyou haveknown the applicant:

Signature:

Date:

Print Name:

Title:

THEPENNSYLVANIAATHLETICTRAINERS'SOCIETY,INC.PATSSTUDENTSCHOLARSHIPPROGRAM

CERTIFIED ATHLETIC TRAINER– PRECEPTORRECOMMENDATION

Student's Name:

(Last)(First)(Middle)

Rating:

Outstanding
Top 5-10% / Excellent Top
25% / GoodTop40% / Unable toJudge
Abilityto Communicate: Verbal
Abilityto Communicate:Written
Abilityto Relateto Co-workers
Initiative and WorkEthic
Dependability/Reliability
Judgment/Common Sense
Accepts Constructive Criticism
Leadership
AbilitytoThinkCreatively
Fitnessfora Career in Athletic
Training
Earnestnessabouta CareerIn
AthleticTraining

CERTIFIEDATHLETIC TRAINER- PRECEPTORRECOMMENDATION

* Continued* What arethe nominee'sgreatest strength's?

Comment on thestudent's current clinical skills (e.g., injuryrecognition, evaluation, taping/wrapping, treatment and rehabilitation, organization and administration, counseling,etc.)

Pleasesummarizethe candidate'sassets, liabilities and potential capabilities for a career as an athletictrainer andwhyyoufeel this applicant is moreworthyof this scholarship than other students in the field.

Signature:Date:

Name Printed:

BOC Cert#:

NPI#:

PA Cert#:

Address:

(Street) (City) (State) (Zip)

Telephone#:

Email Address:

* Reminder: Before mailing in this application besurethat it is complete.Keep a photocopy ofallmaterials foryour records.