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#20-002722-0045
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 possess a bachelor’s degree from an accredited college or university in nursing, social work, psychology, education or counseling?

Yes No
2.

If you do not possess a bachelor's degree from an accredited college or university in nursing, social work, psychology, education or counseling, in what field is your degree?


 

Please be sure to attach an unofficial copy of your transcripts to substantiate all college course work and to document all related experience on your resume.


3.

Describe your level of proficiency with using Microsoft Word, Excel, and PowerPoint. Briefly describe the types of tasks and documents you are able to complete using these applications. 

With your description, include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  This experience must also be reflected in the "Work Experience" section of your application.  If you do not have experience in any of these applications, put N/A in the box below.

 


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