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#24-002818-0010
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1

Describe in 1-3 paragraph(s), your experience collaborating effectively with individuals from diverse backgrounds, demonstrating professionalism and maintaining composure in potentially stressful situations.

Do not copy and paste from your resume. Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

2

Describe in 1-3 paragraph(s), your experience working independently with minimum supervision, demonstrating strong self-motivation and effective time management skills. Please provide specific examples.

Do not copy and paste from your resume. Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

3

Bilingual applicants are encouraged to apply.  Are you able to speak, read and write in both Spanish and English? 

Yes No
4

Describe in 1-3 paragraph(s), your experience with case management (e.g. ability to follow up on appointments and referrals).

If you do not possess experience in this area, enter N/A. Do not copy and paste from your resume. Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.


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