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#19-001362-0021
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 one (1) year of professional work experience in an office that handles worker’s compensation claims. Indicate where and when you gained this experience. (If you do not possess this work experience, enter N/A.)

2

Describe your one (1) year of professional work experience processing workers' compensation claims. Indicate where and when you gained this experience. (If you do not possess this work experience, enter N/A.)

3

Describe your two (2) years of professional work experience in a legal/court setting. Indicate where and when you gained this experience (If you do not possess this work experience, enter N/A.)

4

Describe your experience preparing administrative court orders. Indicate where and when you gained this experience. (If you do not possess this work experience, enter N/A.)

5

Describe and give examples of your level of experience using Microsoft Office Suite (Word, Excel, Outlook and PowerPoint).  If you do not possess experience in this area, put N/A in the box below.


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