OMB APPROVAL
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OMB Number 3235-0287
-------- Expires: January 31, 2005
FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Estimated average burden
-------- Washington, D.C. 20549 hours per response.... 0.5
Check box if --------------------------
no longer subject
to Section 16.
Form 4 or Form 5
obligations may continue.
See Instruction 1(b).
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Chernow David S.
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(Last) (First) (Middle)
4324 East Orchard Lane
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(Street)
Littleton CO 80121
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Select Medical Corporation - NYSE (SEM)
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3. IRS Identification Number of Reporting
Person, if an entity (voluntary)
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4. Statement (Month/Day/Year)
February 21, 2003
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5. If Amendment, Date of Original (Month/Day/Year)
/ /
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6. Relationship of Reporting Person(s)
to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title Other (specify
below) below)
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7. Individual or Joint/Group Filing
(Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting
Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
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1. Title of Security 2. Trans- 2A. 3.Transaction 4. Securities 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) action Deemed Code Acquired (A) Securities Form: Direct Indirect
Date Execution (Instr. 8) or Disposed of Beneficially (D) or Indirect Beneficial
(Month/ Date, if (D) (Instr. 3, Owned Follow- (I) (Instr. 4) Ownership
Day/ any 4 and 5) ing Reported (Instr. 4)
Year) (Month/ Transaction(s)
Day/ (Instr. 3 and 4)
Year)
Code V Amount (A) or Price
(D)
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Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
*If the form is filed by more than one reporting person, see
Instruction 4(b)(v).
(Over)
Potential persons who are to respond to the collection of information
contained in this form are not required to respond unless the
form displays a current valid OMB control number.
Page 1 of 2
FORM 4 (Continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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1.Title of 2.Conver- 3.Trans- 3A. 4.Transac- 5.Number 6.Date 7.Title 8.Price 9.Number 10. Owner- 11.Nature
Derivative sion or action Deemed tion of Exer- and of of ship of
Security Exercise Date Execu- Code Deriv- cisable Amount Deriv- Deriv- Form Indir-
(Instr. 3) Price of (Month/ tion (Instr. ative and Ex- of ative ative of De- ect
Deriv- Day/ Date, if 8) Secur- pira- Under- Secur- Secur- riva- Bene-
ative Year) any ities tion lying ity ities tive ficial
Security (Month/ Ac- Date Secur- (Instr. Bene- Secu- Owner-
Day/Year) quired (Month/ ities 5) ficially rity: ship
(A) or Day/ (Instr. Owned Foll- Direct (Instr.
Disposed Year) 3 and 4) owing Re- (D) or 4)
of (D) ported Indirect
(Instr. Transac- (I)
3, 4 and tion(s) (Instr.
5) (Instr. 4) 4)
Code V (A) (D) Date Ex- Title Amount
Ex- pir- or
ercis- ation Number
able Date of
Shares
Non-qualified Stock
Options
(right to buy) $13.35 02/21/03 A 5,000 (1) 2/20/13 Com- 5,000 5,000 (D)
mom
Stock
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Explanation of Responses:
(1) The option grant of 7,000 options vests over 5 years in
equal parts of 1/5th of the total per year, beginning on 2/21/04.
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a current
valid OMB Number.
/s/ David S. Chernow 02/24/03
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** Signature of Reporting Person Date
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