Official SealDepartment of Budget and Management


#19-000205-0035
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

Do you have a high school diploma or high school equivalency certificate (GED)? (This information must be reflected in the education section of the application)

Yes No
2

Describe your experience in a health care or social services setting.

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.

3

Describe your experience working with adults with serious mental illness and/or those who have experienced homelessness.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.

4

Describe your experience working with the HUD programs.

With your description, include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  This experience must also be reflected in the "Work Experience" section of your application.  If you do not have this experience, put N/A in the box below.

5

Are you fluent in American Sign Language?  

Yes No
6

Please indicate your American Sign Language skill level:

Polite (able to greet and exchange pleasantries; indicate or understand an emergency)
Literate (understands a conversation and can respond)
Fluent (is your native language or can converse in the language as if it was your native language.)
Do not speak sign language.
7

This position requires that the candidate is fluent in Spanish and English, meaning that you must be able to speak, write, and understand both Spanish and English.  Are you bilingual in Spanish and English? 

Yes No
8

Choose the answer that best reflects your ability to communicate in Spanish.

Fluent
Proficient
Intermediate
Beginner
I am not able to communicate in Spanish

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