Official SealDepartment of Budget and Management


#19-003210-0001
Supplemental Questionnaire

Last Name
First Name
1

Candidates must meet one of the following DVOP preference criteria for selection:
 Please indicate which DVOP preference criteria you have:

 

**If you have a Veterans Administration Letter of Disability Rating dated within the last six months please attach it to this application in order to receive credit
qualified serve connected disable veterans:
qualified eligible veterans; and
qualified eligible person {38 U.S.C. 4101(5)}.
none of the above
2

Do you have a Veterans Administration Letter of Disability Rating dated within the last six months? (If yes, please submit a copy with this application.)
Yes No
3

Do you possess one year of experience providing services in a case management environment to veterans? If yes please explain the experience in this area. Include in your response the duties performed,employer names(s),and dates of employment. If you do not possess this experience, please write N/A
4

If yes please explain the experience in this area. Include in your response the duties performed,employer names(s),and dates of employment. If you do not possess this experience, please write N/A

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