Collegiate Strength and Conditioning Coaches Association

APPLICATION FOR PRACTICUM / INTERNSHIP / RESIDENCY / GRADUATE ASSISTANTSHIP

Please have an official transcript sent from your school verifying your credit / graduation status (if an undergraduate.)
Fields marked (*) are required

First Name:*

MI:

Last Name:*

Mailing Address:*: Home Work

Street:*

Street 2:

City:*

State:*

Zip:*

Work Phone:*

Cell Phone:

Fax:

Email:

University/College where you received your degree:

Degree/Area of Study:

Are you Graduated?: Yes No

If no, what's your date of graduation?

Name of your Practicum Mentor:*

Starting Date of your practicum:

Ending Date of your practicum:

When do you plan to take your certification examination Strength & Conditioning Coach Certified (SCCC)?

Academic Degree(s) which you hold (Universty / College only):

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