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#18-000491-0010
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 Bachelor's degree in Nursing, Social Work, Psychology, Education, Counseling or a related field?

Yes No
2.

Please outline the work or experience you have which includes support services and programs for individuals with intellectual disabilities and/or other developmental disabilities.  Detail duties and the dates these duties were performed.  Give specific details.

3.

Describe your professional experience working with individuals with intellectual disabilities (ID).

With your description, include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  This experience must also be reflected in the "Work Experience" section of your application.  If you do not have this experience, put N/A in the box below.

4.

This recruitment has 12 vacancies is 4 different regions, please select which area/areas you are willing to work in:

Central Maryland (Baltimore City)
Southern Maryland (Laurel)
Western Maryland (Hagerstown)
Eastern Maryland (Salisbury)
None of the above

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