**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 current license as a Dietitian/Nutritionist from the Maryland State Board of Dietetic Practice?
Yes
No
If yes, a copy of your license must accompany application.
2.
Do you possess a Master's degree in Dietetics, Nutrition, Institutional Administration or other related field?
Yes
No
3.
What field of study is your master's degree in?
4.
Describe your experience working with a nutrition or dietetic program or service. Please include name of employer(s), job title(s), dates of employment, and hours worked. If this does not apply to you, enter N/A in the box below.
5.
Describe your professional nutrition or dietetic services experience within a residential or hospital setting. This experience must also be included in your application. If you do not possess this type of experience, please indicate N/A in the text box below.
6.
Describe your experience managing a clinical and administrative phase of a dietetic program.
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.
Department of Budget and Management