Official SealDepartment of Budget and Management


#18-004050-0001
Supplemental Questionnaire

Last Name
First Name
1.

Are you willing to work in a correctional facility?
Yes No
2.

Did a Department of Public Safety and Correctional Services employee refer you to this position?
Yes No
3.

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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