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Network Applications & Forms
High Performance Network Application
Applicant must be a current member of USA Swimming (USAS) and a member in good standing of the Sports Medicine and Science Network prior to applying for a Network Internship or High Performance Network status.
*
Last Name
*
First Name
*
USAS Membership ID
Employer/Company Name
*
Business Address
*
City
*
State
*
Zip
*
Business Phone
Other Phone
*
Email
Education and Credentials
*
Credentials and Certifications
Active Release Technique
Bachelor of Arts
Bachelor of Science
Certification of Special Qualifications
Certified Athletic Trainer
Certified Chiropractic Sports Practitioner
Certified Functional Manual Therapist
Certified Massage Therapist
Certified Sport Massage Therapist
Certified Strength & Conditioning Specialist
Doctor of Chiropractic
Doctor of Osteopathy
Doctor of Philosophy
Doctor of Physical Therapy
Licensed Massage Therapist
Master of Arts
Master of Physical Therapy
Master of Science
Medical Doctor
National Certification Board for Therapeutic Massage and Bodywork
Physical Therapist, Certified
Physician's Assistant
Registered Dietitian
Registered Nurse
Comments:
*
List where and when you completed your degrees and certifications.
*
List your license or certification numbers.
Honors/Awards
References
*
List 2-3 people that can speak to your skills and abilities. Include contact information and in what capacity you know this person. Reference #1:
*
Reference #2:
Reference #3
Experience
*
Describe your experience working with swimmers
*
Describe your experience with other athletes
*
Describe your personal experience with swimming
I completed a volunteer rotation with the USOC on the following dates (Not required).
Since completing my rotation with the USOC, I have been invited to attend/cover the following events
*Required