Official SealHuman Resource Services Department


#21-5792-01
Supplemental Questionnaire

Last Name
First Name
1.

Thank you for your interest in the position of Nutritionist I. Applicants for this position are required to submit responses to the following supplemental questions. 

By selecting yes below, you certify your understanding that applicants must meet minimum qualifications in order to move forward in the process.  Do you understand the above statement?

Yes No
2.

By selecting yes below, you certify your understanding of the following:

  • This is an accelerated recruitment.
  • The applications and Supplemental Questionnaires of those candidates who possess the minimum qualifications for the class will be placed directly on the eligible list based on an evaluation of education, training, and experience only. 
  • This recruitment may be reopened as necessary and the names of additional candidates merged onto the existing list according to an evaluation of their application material.
Yes No
3.

This position requires possession of a current Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) certification and good standing with the Commission on Dietetic Registration. Please provide your registration number, issuance and expiration dates in the space provided below.

4.

In the space provided below, please describe your professional work experience in dietetic services or public health nutrition services.  In your response, be sure to include your total number of years of full-time equivalent experience, and the employer where you obtained this experience.

5.

In the space provided below, please describe any additional job-related training and/or education you possess beyond that required by the minimum qualifications.

6.

Do you claim veterans' preference points?

Yes No
7.

Do you claim veterans' service-connected disability points?

Yes No
8.

I understand that to claim veterans’ related preference points, I MUST attach a copy of honorable discharge (DD-214) verification to my application material.  I further understand that if I claim service-connected disability, I MUST also attach proof from the Veteran’s Administration of current disability of 10% or more.

Yes No

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