Official SealDepartment of Budget and Management


#20-004313-0001
Supplemental Questionnaire

Last Name
First Name

 

Please ensure your responses to the following supplemental questions are documented in the spaces provided for each question.  This includes dates of employment and employer information. Otherwise, you will not receive credit for the questions.
1

Do you possess 60 credits from an accredited college or university with at least 15 credits in health services, human services, education or the behavioral sciences?  Please note, you must submit your transcript(s) with the application.
Yes No
2

Describe your experience in providing work placement, work training, and work adjustment services to mentally ill patients or developmentally disabled clients in a pre-vocational development program.
3
Do you possess a bachelors degree in vocational counseling or closely related field?
Yes No
4

Describe your experience with vocation placement in a psychiatric setting.  Also describe your experience documenting patient progress.

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.

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