Graduate Scholarship Sponsoring AT's Eval.
All items with a red asterisk * must be completed. If you do not know the correct response type in unknown or NA.
Applicant's Name
*
Date
*
[MM-dd-yy]
1 = Poor 10 = Excellent
1. Honesty and integrity
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10
2. Responsibility and reliability
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10
3. Organization
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4. Willingness to do the behind-the-scenes unpleasant chores
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10
5. Ability to follow orders
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6. Willingness to work long hours
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7. Shows a personal interest in the athlete
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8. Treats athletes without discrimination
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9. Has an enthusiastic attitude
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10. Demonstrates initiative in work
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11. Ability to get along with colleagues
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12. Personal appearance and hygiene
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13. Mechanical ability
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14. Enforces athletic training room regulations
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15. Stays within the limits of athletic training responsibilities (does not coach or play doctor)
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16. Adhesive taping ability
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10
17. Knowledge of injury evaluation
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18. Knowledge and application of first aid skills
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19. Injury wrapping ability
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10
20. Knowledge and use of athletic training room supplies
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21. Knowledge of general athletic training room administration
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22. Application and knowledge of therapeutic modalities
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23. General knowledge of conditioning exercises
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10
24. General knowledge of basic rehabilitation of injuries
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1
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9
10
25. Ability to construct special injury pads
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1
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9
10
Evaluating Athletic Trainer's Name
*
Evaluating Athletic Trainer's Title
*
Work Phone
*
FAX
*
E-mail
*
Are you a current member of the NATA?
*
-Select-
Yes, I am
No, I am not
NATA Membership Number
*
How many years?
*
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