**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 possess a Master's degree in the field of Public Health from an accredited college or university with a minimum of three graduate courses in Epidemiology and one graduate course in Biostatistics?
Yes
No
2.
If yes, please list the required coursework (three graduate Epidemiology courses and one graduate course in Biostatistics) in the space below using the following format. If no, please indicate N/A. You may also attach a copy of your official or unofficial transcripts to your application:
Example: Course Number Title Credits Earned
EPI 101 Introduction to Epidemiology 3.0
*This information will be verified upon employment.
3.
When did you earn your master's degree (please indicate the month and year)?
4.
Describe your experience as an epidemiologist.
Include name of employer, job title, dates of employment, and hours worked per week for each relevant position. If you do not have this experience, put N/A in the box below.
5.
Describe your supervisory experience. Please describe in detail your experience, including the name of your employers, dates of employment and hours worked per week in the box below. If you do not have this type of experience, please write N/A.
6.
Please describe any experience you have in project management or project administration in the space below. Please provide the name of the organization, job duties, and dates of employment. If you do not have his experience, type "N/A". Please be sure to also include the description in the job duties section of your application to receive credit for this experience.
7.
Describe your experience using electronic disease reporting and/or electronic laboratory reporting systems.
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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