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#20-000383-0002
Supplemental Questionnaire

Last Name
First Name
1.

Describe your resource home experience in the recruitment, training, and retention of foster parents.  Please include name of employer, job title, dates of employment, and hours worked per week. This information must be reflected in your application. If you do not have this type of experience, please indicate N/A.

2.

Do you possess a valid Maryland Graduate MSW license?

Yes No
3.

Do you have five years of child welfare experience? If yes, describe your experience.  Please include name of employer, job title, dates of employment, and hours worked per week. If you do not have this type of experience, please indicate N/A. 

4.

Do you have three years of experience engaging birth/foster families, placement agencies, and other state lead agencies?  If yes, describe your experience.  Please include name of employer, job title, dates of employment, and hours worked per week. If you do not have this type of experience, please indicate N/A.


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