Fall 2024 Volunteer Application: Residency & Fellowship Peer Reviewer

Applicant Information:

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* 1. Please enter your contact information:

First and last name

Email Address

Phone Number

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* 2. Are you currently certified and in good standing with the Board of Certification for the Athletic Trainer (BOC), or equivalent credentialing entity, as well as professional regulatory bodies (no negative practice sanctions)?

Yes

No

Please indicate credentials other than BOC certification

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* 3. Please provide your NPI number if applicable

Application Questions:
Your answers to the following questions will influence the selection process. Please narrate or list your responses.

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* 4. Elaborate on why you are interested in volunteering.

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* 5. Describe how you will ensure diversity, equity, and inclusion are integrated into your contributions as a Residency & Fellowship Program Peer Reviewer.

Application Materials:

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* 6. Please list three references with contact information.

Reference 1

Reference 2

Reference 3

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* 7. Please upload your CV or resume

PDF, DOC, DOCX, PNG, JPG, JPEG file types only.