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#24-002006-0001
Supplemental Questionnaire

Last Name
First Name
1.

Are you a current OPD employee?

Yes No
2.

Do you possess a current license as a Certified Social Worker, Clinical (LCSW-C) from the Maryland Board of Social Work Examiners? 

Yes No
3.

Have you completed a minimum of 18 months as an LCSW-C?

Yes No
4.

Are you a Board-Certified Clinical Supervisor?

Yes No
5.

Describe your background and experience in forensic social work and/or social justice-oriented work.  Include employer, duties and dates of employment.  If no experience, indicate N/A.

6.

Do you have strong written and oral communication skills? If you have this experience, please include the name of employer, job title, dates of employment, and hours worked per week. If you do not have experience in this area, please write N/A.

7.

Describe experience which required you to be detail-oriented and able to meet internal and external deadlines.  Include employer, duties and dates of employment.  If no experience, indicate N/A.

8.

Please explain your ability to balance working as a team and working independently.  Include emplooyer, duties and dates of employment.  If no experience, inidcate N/A.

 

 


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