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#18-003242-0003
Supplemental Questionnaire

Last Name
First Name
1

Are you willing to work in a correctional facility? 

Yes No
2

Are you willing to travel statewide?
Yes No
3

Are you willing to accept contractual employment?
Yes No
4

Do you possess eight (8) years of experience in the building construction field?
Yes No
 

If yes to the question above, please list the name of the employer, and dates employed. If you answered no to the question above, please enter N/A.
5

Did a Department of Public Safety and Correctional Services employee refer you to this position?
Yes No
 

If you answered yes to the question above, please indicate the following:
• Referring employee's full name
• Employee's work location/assignment
If you answered no to the question above, please enter N/A.

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