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#18-005366-0001
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.

Do you possess a Food Service Manager certification (i.e. ServSafe, Certified Dietary Manager)?  If you are responding "YES" to this question, please upload a copy of your certification with the application.

Yes No
 

If you responded YES to the previous question, please indicate in the text box below what type of Food Service Certification you possess.


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