**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 Registered Nurse from the Maryland State Board of Nursing, or a license recognized by the Multi-State Compact agreement?
Yes
No
2
Please provide your license number and expiration date in the box below.
3
Describe in 1-3 paragraph(s), your supervisory experience in a clinical health setting.
Do not copy and paste from your resume. 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.
4
Describe in 1-3 paragraph(s), your experience overseeing budgets and polices in a program.
Do not copy and paste from your resume. 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.
5
Describe in 1-3 paragraph(s), your experience managing a program and monitoring the program’s progress.
Do not copy and paste from your resume. 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.
6
Describe in 1-3 paragraph(s), your experience with care of HIV and/or patients living with HIV.
Do not copy and paste from your resume. 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
Describe in 1-3 paragraph(s), your experience with case management (e.g. ability to follow up on appointments and referrals).
If you do not possess experience in this area, enter N/A. Do not copy and paste from your resume. 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.
8
Describe in 1-3 paragraph(s), your experience working with high risk population (i.e. Substance abuse, HIV, STD Syphilis, etc.)
Do not copy and paste from your resume. 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