{"id":3768,"date":"2025-05-08T11:37:40","date_gmt":"2025-05-08T18:37:40","guid":{"rendered":"https:\/\/backalleychiropractic.com\/?page_id=3768"},"modified":"2025-06-18T06:51:40","modified_gmt":"2025-06-18T13:51:40","slug":"lmt-independent-contractor-application","status":"publish","type":"page","link":"https:\/\/backalleychiropractic.com\/?page_id=3768","title":{"rendered":"LMT (Independent Contractor) Application"},"content":{"rendered":"\n<p class=\"has-text-align-center wp-block-paragraph\">In lieu of this form, resumes and\/or paper applications are being accepted in office at The Back Alley Chiropractic, 2060 E Tangerine Rd #182. Informal on-site interviews are available Mon-Thu 7am to 2pm. A 30-minute practical will be scheduled following informal interview.<\/p>\n\n\n<style id=\"wpforms-css-vars-3776-block-89302963-640c-488d-b1d9-1a5b5797a5c7\">\n\t\t\t\t#wpforms-3776.wpforms-block-89302963-640c-488d-b1d9-1a5b5797a5c7 {\n\t\t\t\t--wpforms-label-color: #000000d9;\n--wpforms-button-background-color: #35727b;\n--wpforms-button-text-color: #dad8cc;\n--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-block wpforms-block-89302963-640c-488d-b1d9-1a5b5797a5c7 wpforms-render-modern\" id=\"wpforms-3776\"><form id=\"wpforms-form-3776\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"3776\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F3768\" data-token=\"d24ec523e3c6e3ce5888ad3a44ec8d26\" data-token-time=\"1792717317\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-3776-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><fieldset><legend class=\"wpforms-field-label\">Full Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" placeholder=\"John\" aria-errormessage=\"wpforms-3776-field_1-error\" required><label for=\"wpforms-3776-field_1\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" placeholder=\"Doe\" aria-errormessage=\"wpforms-3776-field_1-last-error\" required><label for=\"wpforms-3776-field_1-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-3776-field_41-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"41\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_41\">Phone Number <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_41\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][41]\" placeholder=\"(520) 999-1234\" aria-errormessage=\"wpforms-3776-field_41-error\" required><\/div><div id=\"wpforms-3776-field_3-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_3\">Email <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-3776-field_3\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][3]\" placeholder=\"johndoe@sampleemail.com\" spellcheck=\"false\" aria-errormessage=\"wpforms-3776-field_3-error\" required><\/div><div id=\"wpforms-3776-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_4\">Street Address<\/label><input type=\"text\" id=\"wpforms-3776-field_4\" class=\"wpforms-field-large wpforms-limit-characters-enabled\" data-form-id=\"3776\" data-field-id=\"4\" data-text-limit=\"40\" name=\"wpforms[fields][4]\" placeholder=\"123 E City Street\" aria-errormessage=\"wpforms-3776-field_4-error\" maxlength=\"40\" ><\/div><div id=\"wpforms-3776-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_5\">City<\/label><input type=\"text\" id=\"wpforms-3776-field_5\" class=\"wpforms-field-large wpforms-limit-characters-enabled\" data-form-id=\"3776\" data-field-id=\"5\" data-text-limit=\"15\" name=\"wpforms[fields][5]\" placeholder=\"Tucson\" aria-errormessage=\"wpforms-3776-field_5-error\" maxlength=\"15\" ><\/div><div id=\"wpforms-3776-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_6\">State<\/label><input type=\"text\" id=\"wpforms-3776-field_6\" class=\"wpforms-field-large wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"AA\" name=\"wpforms[fields][6]\" placeholder=\"AZ\" aria-errormessage=\"wpforms-3776-field_6-error\" ><\/div><div id=\"wpforms-3776-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_7\">Zip Code<\/label><input type=\"text\" id=\"wpforms-3776-field_7\" class=\"wpforms-field-large wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"99999\" name=\"wpforms[fields][7]\" placeholder=\"12345\" aria-errormessage=\"wpforms-3776-field_7-error\" ><\/div>\t\t<div id=\"wpforms-3776-field_2-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"2\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-3776-field_2\" >been Are received<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-3776-field_2\" class=\"wpforms-field-medium\" name=\"wpforms[fields][2]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-3776-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_13\">Massage School Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_13\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][13]\" placeholder=\"XYZ University\" aria-errormessage=\"wpforms-3776-field_13-error\" required><\/div><div id=\"wpforms-3776-field_14-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_14\">Graduation Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_14\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][14]\" placeholder=\"MM\/YY\" aria-errormessage=\"wpforms-3776-field_14-error\" required><\/div><div id=\"wpforms-3776-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_12\">Arizona License # <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_12\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"MT-99999[9][9]\" name=\"wpforms[fields][12]\" placeholder=\"MT-12345\" aria-errormessage=\"wpforms-3776-field_12-error\" required><\/div><div id=\"wpforms-3776-field_51-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"51\"><fieldset><legend class=\"wpforms-field-label\">Have you ever received a disciplinary action? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3776-field_51\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-3776-field_51_1\" name=\"wpforms[fields][51]\" value=\"Yes\" aria-errormessage=\"wpforms-3776-field_51_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_51_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-3776-field_51_2\" name=\"wpforms[fields][51]\" value=\"No\" aria-errormessage=\"wpforms-3776-field_51_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_51_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-3776-field_19-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_19\">Other Professional Certifications<\/label><input type=\"text\" id=\"wpforms-3776-field_19\" class=\"wpforms-field-large\" name=\"wpforms[fields][19]\" aria-errormessage=\"wpforms-3776-field_19-error\" ><\/div><div id=\"wpforms-3776-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_16\">Relevant Training or Courses<\/label><input type=\"text\" id=\"wpforms-3776-field_16\" class=\"wpforms-field-large\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-3776-field_16-error\" ><\/div><div id=\"wpforms-3776-field_47-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-3-columns\" data-field-id=\"47\"><fieldset><legend class=\"wpforms-field-label\">Areas of Expertise <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3776-field_47\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_1\" name=\"wpforms[fields][47][]\" value=\"Aromatherapy\" aria-errormessage=\"wpforms-3776-field_47_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_1\">Aromatherapy<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_2\" name=\"wpforms[fields][47][]\" value=\"Cranialsacral\" aria-errormessage=\"wpforms-3776-field_47_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_2\">Cranialsacral<\/label><\/li><li class=\"choice-14 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_14\" name=\"wpforms[fields][47][]\" value=\"Cupping Therapy\" aria-errormessage=\"wpforms-3776-field_47_14-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_14\">Cupping Therapy<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_3\" name=\"wpforms[fields][47][]\" value=\"Deep Tissue\" aria-errormessage=\"wpforms-3776-field_47_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_3\">Deep Tissue<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_4\" name=\"wpforms[fields][47][]\" value=\"Hot Stone\" aria-errormessage=\"wpforms-3776-field_47_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_4\">Hot Stone<\/label><\/li><li class=\"choice-15 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_15\" name=\"wpforms[fields][47][]\" value=\"Kiniseo Taping\" aria-errormessage=\"wpforms-3776-field_47_15-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_15\">Kiniseo Taping<\/label><\/li><li class=\"choice-16 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_16\" name=\"wpforms[fields][47][]\" value=\"Lymphatic Draining\" aria-errormessage=\"wpforms-3776-field_47_16-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_16\">Lymphatic Draining<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_5\" name=\"wpforms[fields][47][]\" value=\"Myofascial Release\" aria-errormessage=\"wpforms-3776-field_47_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_5\">Myofascial Release<\/label><\/li><li class=\"choice-13 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_13\" name=\"wpforms[fields][47][]\" value=\"Neuromuscular\" aria-errormessage=\"wpforms-3776-field_47_13-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_13\">Neuromuscular<\/label><\/li><li class=\"choice-17 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_17\" name=\"wpforms[fields][47][]\" value=\"Oncology Massage\" aria-errormessage=\"wpforms-3776-field_47_17-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_17\">Oncology Massage<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_9\" name=\"wpforms[fields][47][]\" value=\"Personal Injury\" aria-errormessage=\"wpforms-3776-field_47_9-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_9\">Personal Injury<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_6\" name=\"wpforms[fields][47][]\" value=\"Pre\/Post-natal\" aria-errormessage=\"wpforms-3776-field_47_6-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_6\">Pre\/Post-natal<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_7\" name=\"wpforms[fields][47][]\" value=\"Reflexology\" aria-errormessage=\"wpforms-3776-field_47_7-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_7\">Reflexology<\/label><\/li><li class=\"choice-11 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_11\" name=\"wpforms[fields][47][]\" value=\"Relaxation\" aria-errormessage=\"wpforms-3776-field_47_11-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_11\">Relaxation<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_8\" name=\"wpforms[fields][47][]\" value=\"Sports Injury\" aria-errormessage=\"wpforms-3776-field_47_8-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_8\">Sports Injury<\/label><\/li><li class=\"choice-10 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_10\" name=\"wpforms[fields][47][]\" value=\"Swedish\" aria-errormessage=\"wpforms-3776-field_47_10-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_10\">Swedish<\/label><\/li><li class=\"choice-12 depth-1\"><input type=\"checkbox\" id=\"wpforms-3776-field_47_12\" name=\"wpforms[fields][47][]\" value=\"Trigger Point\" aria-errormessage=\"wpforms-3776-field_47_12-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_47_12\">Trigger Point<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-3776-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_8\">Current Employment <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_8\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][8]\" placeholder=\"ABC Corporation\" aria-errormessage=\"wpforms-3776-field_8-error\" required><\/div><div id=\"wpforms-3776-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_9\">Job Title <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_9\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][9]\" placeholder=\"Associate\" aria-errormessage=\"wpforms-3776-field_9-error\" required><\/div><div id=\"wpforms-3776-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_10\">Start Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_10\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/dd\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][10]\" placeholder=\"MM\/DD\/YY\" aria-errormessage=\"wpforms-3776-field_10-error\" required><\/div><div id=\"wpforms-3776-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_20\">End Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_20\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/dd\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][20]\" placeholder=\"MM\/DD\/YY\" aria-errormessage=\"wpforms-3776-field_20-error\" required><\/div><div id=\"wpforms-3776-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_11\">Reason for leaving <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_11\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][11]\" aria-errormessage=\"wpforms-3776-field_11-error\" required><\/div><div id=\"wpforms-3776-field_24-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_24\">Job Responsibilities <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-3776-field_24\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][24]\" aria-errormessage=\"wpforms-3776-field_24-error\" required><\/textarea><\/div><div id=\"wpforms-3776-field_25-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_25\">Prior Employment <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_25\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][25]\" placeholder=\"ABC Corporation\" aria-errormessage=\"wpforms-3776-field_25-error\" required><\/div><div id=\"wpforms-3776-field_26-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_26\">Job Title  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_26\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][26]\" placeholder=\"Associate\" aria-errormessage=\"wpforms-3776-field_26-error\" required><\/div><div id=\"wpforms-3776-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_27\">Start Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_27\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/dd\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][27]\" placeholder=\"MM\/DD\/YY\" aria-errormessage=\"wpforms-3776-field_27-error\" required><\/div><div id=\"wpforms-3776-field_28-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_28\">End Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_28\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/dd\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][28]\" placeholder=\"MM\/DD\/YY\" aria-errormessage=\"wpforms-3776-field_28-error\" required><\/div><div id=\"wpforms-3776-field_29-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_29\">Reason for leaving <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_29\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][29]\" aria-errormessage=\"wpforms-3776-field_29-error\" required><\/div><div id=\"wpforms-3776-field_30-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_30\">Job Responsibilities  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-3776-field_30\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][30]\" aria-errormessage=\"wpforms-3776-field_30-error\" required><\/textarea><\/div><div id=\"wpforms-3776-field_31-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_31\">Additional Relevant Employment History<\/label><textarea id=\"wpforms-3776-field_31\" class=\"wpforms-field-medium\" name=\"wpforms[fields][31]\" placeholder=\"ABC Company, Licensed Massage Therapist, April 2000 - April 2001, performed therapeutic massage, relocated to different state.\" aria-errormessage=\"wpforms-3776-field_31-error\" ><\/textarea><\/div><div id=\"wpforms-3776-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_15\">Availbility to Start <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_15\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-3776-field_15-error\" required><\/div><div id=\"wpforms-3776-field_17-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_17\">Preferred Weekly Schedule <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_17\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][17]\" placeholder=\"Monday, Tuesday, Wednesday, Thursday, Friday, Weekends, Weekdays\" aria-errormessage=\"wpforms-3776-field_17-error\" required><\/div><div id=\"wpforms-3776-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_18\">Preferred Daily Hours <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_18\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][18]\" placeholder=\"8 am - 5pm\" aria-errormessage=\"wpforms-3776-field_18-error\" required><\/div><div id=\"wpforms-3776-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_21\">Professional Liability Insurance <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_21\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][21]\" placeholder=\"Allied Professionals Ins Co\" aria-errormessage=\"wpforms-3776-field_21-error\" required><\/div><div id=\"wpforms-3776-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_22\">Liability Limits <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_22\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][22]\" placeholder=\"$6,000,000\/$2,000,000\" aria-errormessage=\"wpforms-3776-field_22-error\" required><\/div><div id=\"wpforms-3776-field_23-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_23\">Policy Term Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_23\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/dd\/yy - mm\/dd\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][23]\" placeholder=\"MM\/DD\/YY to MM\/DD\/YY\" aria-errormessage=\"wpforms-3776-field_23-error\" required><\/div><div id=\"wpforms-3776-field_33-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"33\"><fieldset><legend class=\"wpforms-field-label\">Reference 1 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_33\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][33][first]\" placeholder=\"John\" aria-errormessage=\"wpforms-3776-field_33-error\" required><label for=\"wpforms-3776-field_33\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_33-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][33][last]\" placeholder=\"Doe\" aria-errormessage=\"wpforms-3776-field_33-last-error\" required><label for=\"wpforms-3776-field_33-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-3776-field_34-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_34\">Relationship <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_34\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][34]\" placeholder=\"Colleague\" aria-errormessage=\"wpforms-3776-field_34-error\" required><\/div><div id=\"wpforms-3776-field_35-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_35\">Contact Info <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_35\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][35]\" placeholder=\"(520) 999-1234\" aria-errormessage=\"wpforms-3776-field_35-error\" required><\/div><div id=\"wpforms-3776-field_36-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"36\"><fieldset><legend class=\"wpforms-field-label\">Reference 2 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_36\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][36][first]\" placeholder=\"John\" aria-errormessage=\"wpforms-3776-field_36-error\" required><label for=\"wpforms-3776-field_36\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_36-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][36][last]\" placeholder=\"Doe\" aria-errormessage=\"wpforms-3776-field_36-last-error\" required><label for=\"wpforms-3776-field_36-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-3776-field_37-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_37\">Relationship <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_37\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][37]\" placeholder=\"Mentor\" aria-errormessage=\"wpforms-3776-field_37-error\" required><\/div><div id=\"wpforms-3776-field_38-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_38\">Contact Info <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_38\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][38]\" placeholder=\"(520) 999-1234\" aria-errormessage=\"wpforms-3776-field_38-error\" required><\/div><div id=\"wpforms-3776-field_39-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"39\"><fieldset><legend class=\"wpforms-field-label\">Reference 3 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_39\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][39][first]\" placeholder=\"John\" aria-errormessage=\"wpforms-3776-field_39-error\" required><label for=\"wpforms-3776-field_39\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3776-field_39-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][39][last]\" placeholder=\"Doe\" aria-errormessage=\"wpforms-3776-field_39-last-error\" required><label for=\"wpforms-3776-field_39-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-3776-field_40-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"40\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_40\">Relationship <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_40\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][40]\" placeholder=\"Client\" aria-errormessage=\"wpforms-3776-field_40-error\" required><\/div><div id=\"wpforms-3776-field_49-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_49\">Contact Info <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_49\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][49]\" placeholder=\"(520) 999-1234\" aria-errormessage=\"wpforms-3776-field_49-error\" required><\/div><div id=\"wpforms-3776-field_42-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"42\"><fieldset><legend class=\"wpforms-field-label\">Are you legally authorized to work in the United States? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3776-field_42\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-3776-field_42_1\" name=\"wpforms[fields][42]\" value=\"Yes\" aria-errormessage=\"wpforms-3776-field_42_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_42_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-3776-field_42_2\" name=\"wpforms[fields][42]\" value=\"No\" aria-errormessage=\"wpforms-3776-field_42_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_42_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-3776-field_43-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"43\"><fieldset><legend class=\"wpforms-field-label\">Have you ever been convicted of a felony? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3776-field_43\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-3776-field_43_1\" name=\"wpforms[fields][43]\" value=\"Yes\" aria-errormessage=\"wpforms-3776-field_43_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_43_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-3776-field_43_2\" name=\"wpforms[fields][43]\" value=\"No\" aria-errormessage=\"wpforms-3776-field_43_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3776-field_43_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-3776-field_48-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"48\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_48\">Applicant&#039;s Signature <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_48\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][48]\" placeholder=\"First M.I. Last\" aria-errormessage=\"wpforms-3776-field_48-error\" aria-describedby=\"wpforms-3776-field_48-description\" required><div id=\"wpforms-3776-field_48-description\" class=\"wpforms-field-description\">By entering my full name, I certify that my answers are true and complete to the best of my knowledge. If this application leads to a contracted agreement, I understand that false or misleading information in my application or interview may result in my release.<\/div><\/div><div id=\"wpforms-3776-field_50-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"50\"><label class=\"wpforms-field-label\" for=\"wpforms-3776-field_50\">Signature Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3776-field_50\" class=\"wpforms-field-large wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\"mm\/dd\/yy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][50]\" placeholder=\"MM\/DD\/YY\" aria-errormessage=\"wpforms-3776-field_50-error\" required><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-3776-field_2-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-3776-field_2-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-3776-field_2-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-invisible\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lfl91kgAAAAAPw8wHLL7amxhnEXQlgepZ-N3qhb\" data-size=\"invisible\"><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"3776\"><input type=\"hidden\" name=\"wpforms[time_token]\" value=\"1792717317.2f432e4d075630e8e56b86f9062d8e346c04d774ab7fcc9fa4239fad707f3b72\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/pages\/3768\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-3776\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/backalleychiropractic.com\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"<p>In lieu of this form, resumes and\/or paper applications are being accepted in office at The Back Alley Chiropractic, 2060 E Tangerine Rd #182. Informal on-site interviews are available Mon-Thu 7am to 2pm. A 30-minute practical will be scheduled following informal interview.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3766,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-full-width.php","meta":{"footnotes":""},"class_list":["post-3768","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/pages\/3768","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3768"}],"version-history":[{"count":14,"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/pages\/3768\/revisions"}],"predecessor-version":[{"id":3981,"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/pages\/3768\/revisions\/3981"}],"up":[{"embeddable":true,"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=\/wp\/v2\/pages\/3766"}],"wp:attachment":[{"href":"https:\/\/backalleychiropractic.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3768"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}