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Revolution

Strength Coach Intern Application

Name *

First

Last

Please summarize why you would like to be an intern at RPP *

Address *

Address Line 1

City

State

Zip Code

Mobile Phone *

Email *

Email

Confirm Email

How did you hear about our internship? *

Which session are you applying for (you can select more than one)? *

Winter / Spring
Summer
Fall

Please specify the calendar year your applying for... *

US Citizen *

Yes
No

If no, please explain work permit status... *

Have you ever had a professional license disciplined or revoked? *

Yes
No

If yes, please explain... *

Have you ever been convicted of a crime (including sex or child abuse)? *

Yes
No

If yes, please explain... *

EDUCATIONAL INFORMATION

High School, City and State *

HS Graduation Year *

_______________

1. College, City and State *

Degree and Graduation Year *

_______________

2. College, City and State (if more than one)

Degree and Graduation Year

CERTIFICATIONS, INTERNSHIPS, OTHER, ETC.

List any professional certifications (ATC, CPT, NAMS, CSCS, etc.)

List any certifications achieved through continuing education (FMS, SFMA, etc.)

List any prior internships with dates

REFERENCES (3 REQUIRED)

1. Reference Name *

First

Last

Relationship *

Organization *

Reference Phone *

_______________

2. Reference Name *

First

Last

Relationship *

Organization *

Reference Phone *

_______________

3. Reference Name *

First

Last

Relationship *

Organization *

Reference Phone *

PRIOR EMPLOYMENT HISTORY

1. Company, Address

Supervisor Name

Supervisor Phone

Responsibilities

May we contact this employer?

yes
No

If no, please explain... *

Start and End Dates

Reasons for Leaving

_______________

2. Company, Address

Supervisor Name

Supervisor Phone

Responsibilities

May we contact this employer?

yes
No

If no, please explain... *

Start and End Dates

Reasons for Leaving

MILITARY SERVICE (IF ANY)

Branch of Service

Dates of Service

Service Rank at discharge

DISCLAIMER SIGNATURE

APPLICANT INFORMATION RELEASE SIGNATURE

LIABILITY WAIVER AND RELEASE SIGNATURE

Message

RPP Baseball

40 Eisenhower Drive

Paramus, New Jersey 07652

United States (US)

Phone: (201) 308-3363
Email: rpp@rocklandpeakperformance.com

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