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#18-002596-0003
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.

Do you have at least two years of experience providing case management services to emotionally or socially maladjusted, delinquent, victimized or exceptional juveniles in a community or residential setting.  If so, provide the employer name, dates worked and hours per week worked with the employer. If you do not possess this experience, please enter N/A.

2.

Describe your experience or knowledge of public and private resources and programs for youth and families in need of services that addressed identified needs.   Provide the employer name, dates worked and hours per week worked with the employer. If this does not apply to you, then type 'NA' in the field below.

3.

Please describe your experience and level of participation with placement of youth in a residential setting.    Provide the name of the employer and dates of employment where you gained and applied this experience and hours per week worked.  If this does not apply to you, then type 'NA' in the field below.

 

4.

Describe your experience using the DJS Assist database. In your description, please detail the work performed in the database, your job title at the time and dates of employment. If you do not possess experience using the DJS Assist database, please enter N/A.


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