**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 Bachelor’s degree from an accredited college or university in Public Health Education, Community Health Education or Health Science?
Yes
No
2.
If you do nothave a Bachelor's degree in Public Health Education, Community Health Education, or Health Science, do you have a minimum of 18 credits hours in Public Health Education, Community Health Education, Health Science, or a related behavioral science?
If you answered "yes" to this question, a copy of your transcripts (official or unofficial) must be submitted with your application to receive credit.
Yes
No
3.
Do you possess a Master's degree in Public Health, Community Health Education or Health Science?
Yes
No
4.
Do you possess a Doctorate in Public Health, Community Health Education, Health Science or Public Health Policy?
Yes
No
5.
Describe your experience planning, developing, implementing and promoting health education projects.
Include name of employer, job title, dates employed, and hours worked per week for each position that demonstrates this experience. If you do not have this experience, put N/A in the box below.
6.
Describe your experience evaluating community health education programs.
This experience must also be reflected in the "Work Experience" section of your application. If you do not have this experience, put N/A in the box below.
7.
Describe your experience translating data into community health education products and tools.
This experience must also be reflected in the "Work Experience" section of your application. If you do not have this experience, put N/A in the box below.
8.
Describe your experience which demonstrates your use of effective communication skills, both written and verbal. Include name of employer, dates of employment and job duties. Indicate where this experience is referenced on your application. If no experience, indicate N/A.
9.
Describe your experience communicating effectively with different audiences and conducting stakeholder engagement. Also, describe your skills preparing and using communication plans.
This experience must also be reflected in the "Work Experience" section of your application. If you do not have this experience, put N/A in the box below.
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