YPC Distinction Award Application Page

Direct all questions to Joe Whetstone: maata.d5.ypc@gmail.com

Please allow up to 10 to 14 business days for processing.
It is the sponsor’s responsibility for collecting and electronically submitting the letters of recommendation.

Please write letters of recommendation based on the YPC District 5 Distinction award description.
Please consider including all supporting information about the nominee, personal and professional qualifications, in the letters of recommendation
Three letters of recommendation are the only documents used to select the recipient.
Please do not send any additional materials or documents, they will not be considered.
The YPC will not contact the nominee unless they are selected for the award.

2019 MAATA Young Professionals' Committee Distinction Award Nomination Form

Sponsor Information

Individual completing the nomination form

First Name *

Last Name *

Address *

Address

Address

Address

City

City

State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

State/Province

Zip/Postal

Zip/Postal

Email Address *

Primary Phone # *

Work Fax

Nominee Information

Individual being nominated

First Name *

Last Name *

Education *

Bachelors

Masters

Doctorate

Credentials *

Current Position/Title *

Current Place of Employment *

Address *

Address

Address

Address

City

City

State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

State/Province

Zip/Postal

Zip/Postal

Email Address *

Primary Phone # *

Nominee has been a member of the NATA for at least three years? *

Yes

No

Certified by the BOC? *

Yes

No

Less than 12 years of being certified at time of nomination? *

Yes

No

Years of Athletic Training Experience: *

Letters of Recommendation

Letter of Recommendation #1 *

Drop a file here or click to upload Choose File

Maximum upload size: 268.44MB

Letter of Recommendation #2 *

Drop a file here or click to upload Choose File

Maximum upload size: 268.44MB

Letter of Recommendation #3 *

Drop a file here or click to upload Choose File

Maximum upload size: 268.44MB