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#19-004220-0005
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

This recruitment is limited to current employees of the Frederick County Health Department's Community Health Services Division - Communicable Disease Program.  Are you a current employee within the FCHD Community Health Services Division - Communicable Disease Program?
Yes No
6

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

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