Official SealDepartment of Budget and Management


#19-005398-0017
Supplemental Questionnaire

Last Name
First Name
1.

This is a night shift full-time contractual position, which works from 12 midnight to 8:30 a.m. Are you willing to work from 12 midnight to 8:30 a.m.?

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.


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