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#18-002589-0014
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.

Describe your experience involving one or more of the following:  the supervision of other employees, overseeing and coordinating the general operations of a unit, applying rules and regulations, or exercising responsibility for the development of policies or procedures. In your description, please include the name of employer, dates of employment, your job title, and your relevant job duties. If you no not have this experience, enter N/A.

2.

Describe your experience overseeing procurement activities.

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.

3.

Describe your experience developing long term care policy.

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.


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