Website address of Credentialing Agency
State & State License #
CV (PDF Only)
Proof of Liability Insurance (PDF Only)
Explain credentials and course work training - working with trauma and working with athletes , e.g addiction, eating disorders, LGBT etc... (10000 chars left)
Confirm Email Address
Thank you for submitting your qualifications for review by our Athlete Welfare Advisory Panel. We will notify you via email if you have been approved for listing on the S4A site.
All incomplete applications will not be reviewed. You may resubmit at anytime.
Thank you for helping us make sports safe4athletes!