Official SealDepartment of Budget and Management


#20-005398-0006
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.

Do you have a high school diploma or a high school equivalency certificate? 
Yes No
2.

Describe your experience providing assistance to individuals in a health care or social services 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.
3.

Describe your level of experience using computers.  Please include types of applications and programs used as well.  
4.

Please describe your experience completing multiple tasks in a busy work environment.  If you do not possess this type of experience, please indicate N/A in the text box below.
5.

The candidate selected for this position must be willing to work evenings, weekends and holidays. Are you willing to work evenings, weekends and holidays?
Yes No
6.

Please select the type of employment that you are interested in below (you may select both if interested in both options):
Full-Time
Part-Time

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