Official SealDepartment of Budget and Management


#21-001992-0001
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

This recruitment has several vacancies located throughout Maryland in four Regional Offices within the Developmental Disabilities Administration.  Please select ONLY the areas in which you are willing to accept work.  Please note that the Eastern Shore and Western Maryland Regional Offices are located over 2 hours away from Baltimore City.

Central Maryland Regional Office, Baltimore MD (Baltimore City)
Eastern Maryland Regional Office, Salisbury, MD (Wicomico County)
Southern Maryland Regional Office, Laurel, MD (Prince George's County)
Western Maryland Regional Office, Hagerstown MD (Washington County)
2

Do you currently possess a license as a Certified Social Worker (LCSW) or Certified Social Worker, Clinical (LCSW-C) by the Maryland State Board of Social Work Examiners?

Yes No
3

If you answered Yes to the previous question, please provide the license number and expiration date in the box below.  A copy of your current license or license verification should also accompany your application.

4

Describe your professional work experience rendering clinical social work services in a health care or treatment setting subsequent to the receipt of an approved Master's degree in Social Work from an accredited college or university.

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.

5

Describe your knowledge of and/or experience with DDA Programs. This experience should also be reflected in your application.

6

Describe your experience working with individuals with behavioral challenges.

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.

7

Describe your knowledge and experience in case management.

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 this experience, put N/A in the box below.

8
Do you possess a valid driver's license?
Yes No

Powered by JobAps