Official SealDepartment of Budget and Management


#19-005479-0004
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 from an accredited college or university in public health, nursing, social work, or related field?

Yes No
2.

Please list the field of your bachelor's degree.

3.

Do you possess a master's degree from an accredited college or university in public health, nursing, social work, or related field?

Yes No
4.

Please list the field of your master's degree.

5.

Do you possess at least five years of professional experience in public health and/or related field specifically associated with maternal and child health programs?

Yes No
6.

Describe your professional health and/or human service experience, specifically as it relates to maternal and child health program implementation, oversight, management, and/or evaluation.

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.

7.

Do you have at least three years of professional experience in developing budgets, monitoring and tracking expenditures, and contract preparation, management, and/or oversight?

Yes No
8.

Describe your professional experience in developing budgets, monitoring and tracking expenditures, and contract preparation, management, and oversight.

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.

9.

Do you have at least three years of professional experience in staff recruitment, retention, and personnel management?

Yes No
10.

Describe your professional experience in staff recruitment, retention, and personnel management.

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.


 

**A copy of your resume and college transcripts must accompany your application.  Transcripts may be unofficial.**



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