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.***


Do you possess a Bachelor's Degree in a Social and Behavioral Science major, such as Criminal Justice, Sociology, Human Relations, Psychology, Child and Adolescent Studies, and Social Work? 

Yes No

Do you possess at least one year of experience providing direct services to children in a community or residential setting. If so, please include employer name, dates of employment, hours worked per week and duties. If you do not have this experience, type N/A.

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