Complete this form if you did not complete a program registered by the New York State Education Department as licensure qualifying or accredited by the National Athletic Trainers' Association, the Commission on Accreditation of Allied Health Programs or by the Commission on Accreditation of Athletic Training Education. The Office of the Professions will not accept this form if submitted by the applicant.
- Section I: Complete this section of the form before sending the entire form to your supervisor. Be sure to sign and date item 8.
- Section II: Your supervisor must complete this section and return both pages of the form in an envelope with their return address directly to the Office of the Professions at the address at the end of the form.