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Supplemental Questionnaire

Last Name
First Name


Supplemental Questionnaire

INSTRUCTIONS: Completion of this supplemental questionnaire is REQUIRED. Please read each question carefully and provide clear and complete responses that accurately portray your education and relevant work experience. Your qualifications for employment will be evaluated based upon the information you provide in your responses below and then verified by our staff who will review your entire application for completeness and determine qualification status.

The employers and dates of employment that you list on this supplemental questionnaire MUST match the employers and dates of employment provided in the work experience section of your employment application. Failure to provide matching employer, and dates of employment may result in your application being "not qualified" for this recruitment.

IMPORTANT NOTE: "See Resume" is not an acceptable response to any of the open-ended questions on this questionnaire and will result in your application being "not qualified" for this recruitment.


Have you graduated from an accredited four year degree granting college or university in Early Childhood Education or a related field; or four year degree in any field with 18 credit hours in Early Childhood Education; and One year of experience in teaching Head Start, Early Head Start, pre-school or kindergarten age children?

Yes No

Have you completed the FL DCF 40 clock hour requirement?

Yes No

Do you have at least 2 years of teaching experience working with Head Start, pre-school, or kindergarten aged children? (Years of experience are based on Full Time work schedule; i.e. 40 or more hours per week).

Yes No

Please provide a narrative supporting your answer to the above question.  Be sure to include the specific job title, job duties, and the organization and dates where the work was performed.


Are you willing to work anywhere in Hillsborough County?

Yes No

Do you have experience with Teaching Strategies Gold Online assessment or any other online assessments? 

Yes No

If you answered yes to the above question, please explain the online assessment used and how you used the online assessment to individualize activities within your classroom.


Describe the strategies you implement in the classroom to provide individualization for ELL and children with disabilities.


What experience do you have in the Implementation of the DLM Curriculum or any other scientifically based curriculum?


How do you use data to drive instruction?


Are you a past or current Head Start parent or past Head Start student?

Yes No

Have you ever been employed by Hillsborough County Head Start/Early Head Start Program or any of its delegates or contracted sites? 

Yes No

If so, what were your dates of employment?


Do you possess a valid Driver's License?

Yes No


By checking the box above, I certify that all of my responses are true and complete, and any misstatement of material facts OR failure to completely answer questions or provide my employer with a copy of any licenses, certifications, or other documents listed on the job announcement will subject me to disqualification from the application process and/or dismissal from employment.

I also authorize investigation of all statements contained in my application, to include a formal background check that may require education and employment verification; criminal history; and motor vehicle driving report as may be necessary in arriving at an employment decision. Further, I acknowledge understanding that an offer of employment will be subject to successfully passing a drug screen and physical.

I also understand that once I submit my application for this recruitment, I cannot edit it later.