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#24-004934-0001
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 your experience involving planning, coordinating and evaluating volunteer activities in a state facility, institution or community based program. If you do not possess experience in this area, indicate N/A in the box below.

Please include name of employer, job title, dates of employment and hours worked per week. This information must also be reflected in your application.

2

Do you possess a Bachelor's degree from an accredited college or university to include 30 credit hours in social sciences, journalism, public relations or a related field? Please attach transcript(s) to application (unofficial versions are acceptable).

Yes No
3

Describe your experience working with adolescents with emotional disabilities and court involved youth.

This experience must also be included on your application. Please be sure to include name of employer, job title, dates of employment and hours worked per week. If you do not possess experience in this area, indicate N/A.

4

Please describe your experience using Microsoft Office including Word, Excel, PowerPoint, and Publisher. If you do not have this experience, please enter N/A.


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