***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
Describe your experience providing substance abuse counseling to youth. Include place of employment, dates and job duties. If no experience, indicate N/A.
2
Describe your experience creating treatment plans. Include place of employment, dates and job duties. If no experience, indicate N/A.
3
Describe your experience performing intakes and assessments for admission to alcohol and drug treatment programs. Include place of employment, dates and job duties. If no experience, indicate N/A.
4
Describe your case management experience. Include place of employment, dates and job duties. If no experience, indicate N/A.
5
Describe your experience in crisis intervention. Include place of employment, dates and job duties. If no experience, indicate N/A.
6
Do you have a Letter of Authorization issued by the Maryland Board of Professional Counselors and Therapists? (If Yes, please upload a copy with your application).
Yes
No
7
Do you have a CSC or CAC issued by the Maryland Board of Professional Counselors and Therapists? (If Yes, please upload a copy with your application).
Department of Budget and Management