**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.
Are you a current merit employee of the Charles County Department of Health's Substance Use Department?
Yes
No
2.
Do you currently possess a license as a Certified Professional Counselor-Alcohol and Drug OR Licensed Clinical Alcohol and Drug Counselor from the Maryland Board of Professional Counselors and Therapists?
Yes
No
3.
If you answered yes, please attach a copy of your license to your application. Also, provide the license number and expiration date below.