If you would like to join the USAW Team California Sports Medicine
staff please PRINT this page and submit your application in paper form.
Applications can NOT be submitted in electronic form.  Send your application
to:
    
    Robert Valerio
    5325 W. Clinton
    Fresno, CA 93722
    ATTN: Sports Medicine Staff Application

For further information, contact Dustin Hopfe, Director of Sports
Medicine for California USA Wrestling. email: dhopfe@hotmail.com

Name_______________________________________________________

Address____________________________________________________

City___________________________  State_______  Zip_________

Phone(s)___________________________________________________

Email______________________________________________________

Your business or school____________________________________

Certified Athletic Trainer_________________________________

Student Athletic Trainer___________________________________  

If student, what year in school____________________________

Have you ever worked wrestling before?_____________________

If so, where?______________________________________________

How much wrestling experience do you have?_________________

___________________________________________________________

___________________________________________________________