Collegiate Strength and Conditioning Coaches Association

M E M B E R S H I P A P P L I C A T I O N 2008/2009

FOR ALL FULL-TIME, HEAD AND ASSISTANT STRENGTH AND CONDITIONING COACHES OF PROFESSIONAL ATHLETIC TEAMS/PROGRAMS
Fields marked (*) are required

First Name:*

MI:

Last Name:*

SSN:

Gender:

Strength & Conditioning Position:*: Head Assistant

Athletic Team/Program (NFL, NBA, WNBA, MLB, Etc):*

Mailing Address:: Home Work

Street:*

Street 2:

City:*

State:*

Zip:*

Work Phone:*

Cell Phone:

Fax:

Email:

Academic Degree(s) which you hold (University/College Only):

Institution:

Degree & Year Received :: add another degree

Employment History*

University/Collegiate and/or Professional (e.g. NFL, NBA, MLB, NHL, etc.) Employment History. (Please begin with current position and work back, including only those jobs at which you were a full-time, head or assistant strength & conditioning coach. Positions as interns, residents, graduate assistants, practicum students, etc. and dual role positions as part-time head or assistant strength & conditioning coach and sport coach/athletic trainer/physical therapist/teacher/researcher/etc. will not be counted as full-time employment.) Please be as accurate as possible. Listed institutions will be contacted for verification of employment history. Use attachments as necessary.

Institution / Organization:*

Position:*

From:*

To:*: add another job

Total:: Number of Years as a Full-time Head or Assistant Strength and Conditioning Coach

Fees:: Amount Due: $100; Credit Card; Check
Make Check Payable to:; Collegiate Strength & Conditioning Coaches assoc. (CSCCa)
P.O. Box 7100
University Station
Provo, UT 84602

M E M B E R S H I P A P P L I C A T I O N 2008/2009

Mailing Address:

Academic Degree(s) which you hold (University/College Only):

Employment History*

Fees: