Physical Therapy Student Clinical Affiliation Program Application

If you are interested in applying for the Physical Therapy Student Clinical Affiliation Program at NYU Langone’s Harkness Center for Dance Injuries, please complete and submit the application below. Positions are offered in the spring semester only (January through May); you must submit your application by January 31 of the year before your desired starting date.

In addition to submitting your application, please also send the following materials to harkness@nyulangone.org:

copies of unofficial transcripts of your university education to date, including modules or classes you have taken
copies of certificates for additional qualifications
two letters of recommendation

Indicates required field

First and Last Name

Date of Birth

Phone

Email Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Undergraduate Institution

Degree Program

Additional Degrees or Certifications and Dates Earned

Type of Dance Studied. Provide the name of the school or company and dates attended.

Date Range Available for Physical Therapy Student Clinical Affiliation Program

Career Aspirations

Reference No. 1

Reference No. 2

Reference No. 3

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Physical Therapy Student Clinical Affiliation Program Application | NYU Langone Health

Physical Therapy Student Clinical Affiliation Program Application