Prospective Student Questionnaire

Subject: *

First name: *

M.I.:

Last name: *

Email: *

Address: *

City: *

State: *

Zip: *

Home phone: *

Format as xxx-xxx-xxxx

Cell phone:

Format as xxx-xxx-xxxx

Previous school attended: *

Anticipated graduation/transfer date: *

GPA: *

Class rank:

ACT score:

SAT score:

Career of interest: *

Select all that apply

Any clinical experiences: *

PT Aide, Athletic training student, etc.
If none, type NONE

Did your high school have an Athletic Trainer?: *

Yes

If so, who?:

What is your idea of what a Certified Athletic Trainer does?: *

Tell us a little about yourself. What makes you a great potential candidate for the NWU ATEP?: *

Do you have any questions or comments about the program?:

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Health and Human Performance Department