Official SealHuman Resource Services Department


#20-0305-03
Supplemental Questionnaire

Last Name
First Name
 

Thank you for your interest in the Program Specialist (Registered Dietitian, Certified Diabetes Educator, Spanish Speaking) position. Applicants for this position are required to submit responses to the following supplemental questions. Your completed responses to the supplemental questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process. Additionally, your responses will also be evaluated and used in the selection process in order to identify the best qualified applicants.

Responses should be thorough and specific. A lack of detail and explanation in the supplemental questions and in your application may result in failure or disqualification for this position. Clarity of expression, content, experience, grammar, spelling and the ability to follow instructions will be considered in the evaluation process. A resume will not be accepted as a substitute for properly completed responses.

Information provided in your responses to the supplemental questionnaire regarding your employment experiences must also be detailed in the Work Experience section of the application for this recruitment. Please be sure to list all employers and required information, on your application, especially if you are referencing those employers in your responses to the supplemental questions.

By selecting yes below, you certify your understanding that all applicants are required to submit complete responses to the supplemental questions and a complete application in order to be considered for this recruitment. Do you understand the above statement?

Yes No
1.

Please describe the training, education and experience you possess which makes you the best qualified candidate and what is your interest in the position?

2.

In the field below, please provide your Registered Dietitian license number. Also, please attach a copy of your Certified Diabetes Educator certificate with your application under the "Resume" tab.

2a.

Have you attached a copy of your Certified Diabetes Educator certificate to your application? Please note, only ONE (1) attachment is allowed to be uploaded at a time. If attaching multiple documents, please scan together and attach as ONE (1) document.

Yes No
3.

Please describe how you have demonstrated your ability to mobilize and foster community partnerships related to public health and health education.

4.

Please describe your fiscal and contract management experience. In your response, describe your role, duties, responsibilities and employers name and dates.

5.

Describe your experience in grant writing, implementing grant deliverables and reporting on the outcomes. In your response, provide details of your responsibilities and roles.

6.

Please describe your experience integrating strategies that address health equity and the social determinants of health into service delivery systems.

7.

Please describe your experience in training peer educators, providing continuing education and overseeing their work in the community or classroom setting. What experience do you have in creating diabetes curriculum and training programs?

8.

Are you able to speak, read, and write fluently in Spanish?

Yes No
 

The supplemental questions were designed to elicit your experience as it relates to the current recruitment in order to identify the best qualified candidates for this position. Only the best and most suitably qualified candidates will be invited to participate in the oral interviews.

By selecting yes below, you certify your understanding that all applicants who meet minimum qualifications are not guaranteed to move forward in the process.

Do you understand the above statement?

Yes No

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