Official SealDepartment of Budget and Management


#19-005477-0017
Supplemental Questionnaire

Last Name
First Name
1

Do you possess a current license as a Dietitian/Nutritionist from the Maryland State Board of Dietetic Practice?

Yes No
2

Do you possess a current ServSafe certification or Food Handler's License. If so, please 

specify. If not, please type N/A.

3

Do you have knowledge of food systems management, including the purchasing, receiving, storage, preparation, and service of meals to youth is highly desirable. If so, include employer name(s), dates of employment, job duties and hours worked per week. If not, type N/A. *


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