BOC - Volunteer Apps

* Volunteer position(s) you are applying for:Exam Development Item WriterNominating CommitteeProfessional Practice and Discipline CommitteeStandards CommitteeOther task force, advisory panel, work group

Other (please specify)

Personal Information

* Certification Number

In what state(s) are you Licensed/Certified/Registered as an Athletic Trainer?

Have you ever been disciplined by a state regulatory board or agency?

If yes, provide an explanation.

Have you ever been disciplined by an employer that affected your employment status?

If yes, provide an explanation?

Current Employer

Athletic Trainer Leadership Experience

Athletic Trainer Leadership Experience #1

Organization

Role

Position

Start Date (MM/YYYY)

End Date (MM/YYYY)

Other Leadership Experience

Other Leadership Experience #1

Organization

Position

Start Date (MM/YYYY)

End Date (MM/YYYY)

Questions

* What are your area(s) of expertise?

* What are your area(s) of interest?

* What are your area(s) of focus?

* Why do you want to volunteer for the BOC and what unique perspective or skill will you bring to the BOC?

* Do you have access to a secure internet connection?YesNo

* Is your work area private and secure?YesNo

* Do you have access to a wide variety of current athletic training references?YesNo

* Currently, are you DIRECTLY involved with the teaching/preparation of BOC exam preparation materials and/or do you have an appearance of a conflict of interest? (A conflict of interest is a situation in which a person or organization is involved in multiple interests (financial, emotional or otherwise), one of which could possibly corrupt the motivation of the individual of organization.)YesNo

* Some volunteer positions require a larger commitment than others. However, the BOC encourages all volunteers to be transparent with their employers and discuss any potential conflicts. Have you discussed your desire to serve as a volunteer for the BOC and the time commitment with your employer?YesNo

Volunteer Application

Personal Information

Current Employer

Athletic Trainer Leadership Experience

Other Leadership Experience

Questions