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#18-003105-0001
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.***


1

Please describe your experience multi-tasking and working independently. If you do not possess this experience, indicate NA in the box below.

2

Please describe your experience in small equipment repair and basic vehicle maintenance. If you do not have this experience, indicate NA in the box below.

3

Please describe your experience working with volunteers to complete projects. If you do not possess this type of experience, indicate N/A in the box below.

4

Are you a graduate of the Work2Live WELL program?

Yes No

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