The Clubhouse Clinical Team Member Application

The Clubhouse

Clinical Team Member Application
Are you ready to help children thrive?

We are excited to start this process with you!
Complete this application below, and we will be in touch soon.

Have a question? Email careers@clubhousetherapy.com
Full Name*

First NameLast Name
Phone Number*
Email Address*
example@example.com
How did you hear about The Clubhouse?*

FriendWebsiteSocial MediaGoogleOther
What about The Clubhouse prompted you to apply?*
Which clinical position are you applying?

Speech Language PathologistBCBAPhysical TherapistRBTOccupational TherapistLCSWOther
What are your goals for this position?*
How do you desire to grow in your first year at The Clubhouse?*
In a team environment, what role do you typically take on?*
We make learning fun! What fun hobbies do you enjoy outside of work?*
What is your preferred location(s)?*

Downers GroveNorth Mayfair (Chicago)
What is your preferred setting? Check all that apply. *

Schools (Public, Private, Charter)ClinicOther
What is your preferred work schedule?*

Full-TimePart-timePRN
Are you available to work after school hours?*

YesNo

Professional References*

	Full Name	Email Address	Phone Number	Relationship	Location
Former or Current Supervisor Reference
Reference

The Clubhouse