Careers

Job Application Form

JPM PHYSICAL THERAPY is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Please fill out all of the sections below:

Step 1 of 6

Applicant Information

Applicant Name

Address

Street Address City State ZIP Code

Telephone Number

Email Address

Date of Application

Previous Employment

Employer Name

Job Title

Supervisor Name

Employer Address

Street Address City State ZIP Code

Dates Employed

Reason for leaving

Employer Name

Job Title

Supervisor Name

Employer Address

Street Address City State ZIP Code

Dates Employed

Reason for leaving

Employer Name

Job Title

Supervisor Name

Employer Address

Street Address City State ZIP Code

Dates Employed

Reason for leaving

References

Please provide 3 personal and professional reference(s) below:

Reference

Contact Information

Additional Information

Are you willing to follow company rules and policies?

Are you inclined to undergo training without pay?

Are you eager to learn and follow instructions?

Are you a team player or able to work with someone?

AT-WILL EMPLOYMENT

The relationship between you and the JPM PHYSICAL THERAPY is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the JPM PHYSICAL THERAPY. No representative of JPM PHYSICAL THERAPY has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations OfÏcer or the Company's President.

Applicant Signature

Dated

CAPTCHA

Careers

Job Application Form

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

High School

College/University

Vocational School/Specialized Training

Military

Previous Employment

Employer Name

Employer Name

Employer Name

References

Additional Information

AT-WILL EMPLOYMENT

JPM Physical Therapy Office Locations

Ozone Park

Queens Village

Elmhurst

Elmhurst #2 (Rehab)