Physical Therapists (Pediatrics)

Job Code: 1568788 Location: Manhattan

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* FIRST NAME	M.I.	* LAST NAME

* HOME PHONE (xxx)xxx-xxxx	WORK PHONE (xxx)xxx-xxxx

* EMAIL

* ADDRESS

* CITY	* STATE/PROVINCE	* POSTAL CODE

* COUNTRY

1. HAVE YOU EVER BEEN AN EMPLOYEE OF YAI/NYL? *

Yes
No

2. IF YES, PLEASE INDICATE WHEN, THE NAME OF THE PROGRAM AND THE NAME OF YOUR SUPERVISOR.

3. ARE YOU LEGALLY EMPLOYABLE UNDER U.S. IMMIGRATION LAWS? (PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT). *

Yes
No

4. IF NO, PLEASE INDICATE IMMIGRATION STATUS

5. ARE YOU NYSED LICENSED AS A PHYSICAL THERAPIST? *

Yes
No

6. IF NO, PLEASE INDICATE ANTICIPATED DATE LICENSE WILL BE OBTAINED.

7. DO YOU HAVE EXPERIENCE EVALUATING AND TREATING CHILDREN AGES BIRTH TO FIVE WITH SPECIAL NEEDS? *

Yes
No

8. WHICH LOCATIONS ARE YOU INTERESTED IN? PLEASE SPECIFY IN ORDER OF PREFERENCE *

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9. PLEASE INDICATE YOUR DESIRED POSITION. *

Homebased Fee-For-Service
Full-Time Centerbased Preschool
Part-time Centerbased Preschool

10. PLEASE SPECIFY YOUR MINIMUM SALARY REQUIREMENT. *

* PLEASE PASTE A COPY OF YOUR RESUME OR PROFILE BELOW.