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#18-002247-0074
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.

This recruitment is limited to current employees of the MDH Holly Center.  Are you a current employee of the MDH Holly Center?

Yes No
2.

Describe your experience working in a health care setting with persons with developmental disabilities. This experience should also be included in your application.  If you do not possess this type of experience, please indicate N/A in the text box.

3.

Describe your experience working on an interdisciplinary team to coordinate care for persons with developmental disabilities.  This experience should also be included in your application.  If you do not possess this type of experience, please indicate N/A in the text box.

4.

Describe your experience supervising and scheduling staff assigned to a residential unit.  This experience should also be included in your application.  If you do not possess this type of experience, please indicate N/A in the text box.


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