Official SealDepartment of Budget and Management

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.***


Are you at least 21 years of age?


Yes No

Are you a U.S. Citizen or Legal Resident Alien?

Yes No

Did a Department of Public Safety and Correctional Services employee refer you to this position?

Yes No

If you answered yes to the question above, please indicate the following:
• Referring employee's full name
• Employee's work location/assignment
If you answered no to the question above, please enter N/A.

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