This page requires JavaScript. If you cannot see the shifts below and cannot turn JavaScript on please contact us for assitance. Thank you for your interest in becoming a Herman & Wallace Teaching Assistant. Please fill out the below application if you are interested in serving as a teaching assistant at our continuing education courses.We will review your application and get back to you in 3-5 business days. Access your profile Scroll to see more shifts & complete your submission at the bottom of the page.Click here to scroll down. What's your email address? Your email address: Your informationRequired fields are marked with an asterisk (*). One of the fields below requires a file upload/attachment, the file size must be less than 10MB.What is your first name? *What is your last name? *What are your professional credentials (MPT, DPT...)? *What States are you available to assist in? Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington DC Washington State West Virginia Wisconsin WyomingHow comfortable are you with using technology? (Zoom, Teachable) *Are you PRPC Certified? *Please describe your current work setting and patient population. *How many internal assessments/ treatments of the pelvic floor do you perform a week? *What courses have you taken with Herman & Wallace? *If you have not taken your Pelvic PT courses with Herman & Wallace, where were they taken? What did you take? When were they taken? *What is your T-Shirt Size?XSSMLXL2XL3XLOther comments that would help us learn more about you * *Please upload a copy of your ResumeSelect fileThe total size of any/all file uploads must be less than 10MB
