Full Name: Degree Major with University and Completion Year: Total Years of Athletic Training Experience: Total Years of High School / School District Athletic Training Experience: Washington State Athletic Trainer License Number (Active): BOC Certification Status (Active & in Good Standing – Yes/No): NPI Number: CPR / First Aid / AED Certification (Healthcare Provider Level – Expiration Date): Please describe your most recent Athletic Training assignment (School/Organization, Sports Covered, Role, Coverage Hours, Outcomes): Please list sports you have supported (Football, Basketball, Soccer, Wrestling, etc.) and approximate years of coverage for each: Are you available to provide up to 1,676 hours per school per contract year? (Yes/No): Motivation/Reason for Interest in This Role: Contact Number: Email ID: LinkedIn Profile URL: Full Address (Street, City, State, ZIP Code): Notice Period (in weeks): Current Work Authorization Status (e.g., US Citizen, Green Card, H1B, etc.): Expected Hourly Rates: Is it W2 / C2C, If C2C, May I know your corporation name?.