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#24-005055-0012
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.

Please describe your experience in providing technical assistance to various, diverse audiences. In your response include the name of employer, dates of employment, your job title, and your relevant job duties. If you do not have this experience, enter N/A.

2.

Please describe your experience with coordinating, monitoring or administering Special Education Assessments. In your response include the name of employer, dates of employment, your job title, and your relevant job duties. If you do not have this experience, enter N/A.

3.

Please describe your experience in providing technical guidance for accommodation, accessibility, and special education as they relate to instruction and testing for students with disabilities. In your response include the name of employer, dates of employment, your job title, and your relevant job duties. If you do not have this experience, enter N/A.


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