DPT Profile Form - Wheeling Jesuit University

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WHEELING JESUIT UNIVERSITY
Department of Physical Therapy
316 Washington Avenue
Wheeling, West Virginia 26003
304-243-2432
wjudpt@wju.edu

PERSONAL PROFILE
For anticipated entrance into the
Doctor of Physical Therapy Program:
Fall 2011

Last Name

First Name

M.I.

Address
City State Zip

Telephone (with area code)

E-mail address

Birthdate

Preferred communication:
E-mail Telephone

The description that best fits me is:
Full-time student Working professionalDegreed professional

I am currently attending: (college or university name)

My current grade point average is

Current college or university major

Expected graduation (semester/year)

I am looking for a PT program that emphasizes:

	Clinical experience	Service Learning
	Faculty mentoring	Small class size
	Interactive learning

Other: Please describe


The area of PT I would like to specialize in:

	Cardiopulmonary/Exercise Science	Orthopedics
	Generalist	Pediatrics
	Geriatrics	Sports Medicine
	Neurological Rehabilitation

Other: Please describe


My anticipated career plans after PT school are:

	Administration in a clinical setting	Private practice - own my own business
	Clinical specialization	Work as a clinician
	PhD program

I have had PT clinical experiences in: