**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 current Certified Nursing Assistant license in Maryland?
Yes
No
2.
If you currently possess a current Certified Nursing Assistant license, then type your CNA license number in the field below. Please note that you are required to upload a copy of your license with your application.
If you do not have a CNA license, then type "N/A" in the field below.
3.
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
4.
Explain your experience providing residential services in a developmental disability or similar behavior modification 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.
5.
Describe your experience providing supervision and guidance to staff in a residential facility or community program for developmentally disabled residents.
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.
6.
Describe your experience developing and maintaining adequate staffing schedules.
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.
Department of Budget and Management