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#18-005476-0021
Supplemental Questionnaire

Last Name
First Name

 

Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.


1.

Do you possess a bachelor's degree from an accredited college or university in business, communications, or a mathematics related major?  If so, please indicate field of study in the box below.  If no, please write N/A.

2.

What is the major field of study for your bachelor's degree? If you answered "No" to the previous question, please enter N/A in the box.

3.

Describe your professional experience in a viral hepatitis (Hepatitis B or Hepatitis C) related program.

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 on your resume.  If you do not have this experience, put N/A in the box below.

4.

Describe your experience working with HIV Programs.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

5.

Describe your experience at the supervisory or managerial level.

Please include name of employer, job title, title(s) of those you supervised or managed, number of employees supervised, dates of employment, and hours worked per week for each relevant position.  This information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 


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