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#21-002599-0001
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 employment experience within the last 18 months? Please include employer name, dates of employment, duties, and hours worked per week. If you do not have any employment experience with the last 18 months, type N/A.

2.

Do you possess an Associates Degree or higher in a related field (i.e., Criminal Justice, Social or Behavioral Sciences)? If so, please explain. If you do not possess a degree in a related field, type N/A.

3.

Have you successfully completed pre-screening with DJS within the last year?

Yes No

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