Official SealPersonnel Commission


#24-4076-001
Supplemental Questionnaire

Last Name
First Name

 

INFORMATION AND INSTRUCTIONS: The information you provide on the standard application form and on this supplemental questionnaire will be used to evaluate your qualifications for this position.  Your responses to this questionnaire must be supported by the information on your application to be considered.  Resumes or referral to a resume in lieu of a response will not be accepted. 

You are responsible for including all important information in your responses. The information you provide is subject to verification. Errors or omissions may affect your rating or consideration for employment. 


1

Are you physically able to lift and move items weighing up to 50 lbs?

Yes No
2

Do you have 1yr of full-time, paid janitorial or custodial experience with a single employer?  

If you answer YES, please be sure to include the experience in the WORK tab.

Yes No
3

Have you successfully completed a custodial training course of at least 60 hours?

Yes No

4

If you answered YES please provide the following information: 


 

Name of Institution 

 

Title of Course Completed 

 

Hours of Training completed 

 

Date Completed


 

If you have completed a Custodial Training course of at least 60 hours please upload the certificate in the “Other” tab. You may select N/A to submit your application without uploading a certificate.