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#20-000221-0001
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.

Have you ever worked as an investigator or done an internship as an investigator for a medical examiner or coroner's office? 

Yes No
2.

If yes, please explain.  Include job duties, place of employment, dates and hours worked per week.  This information must also be reflected in your application.  If no experience, indicate n/a.

3.

If your answer to question 1 is yes, please indicate the approximate number of death scenes that you have investigated.

4.

Describe your experience responding to death scenes.  Please include place of employment, job title, dates employed, hours worked per week and a description of your job duties.  If you do not have this experience, put N/A in the box below.

 

5.

Describe your experience with trauma care or EMS.  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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