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#21-002586-0050
Supplemental Questionnaire

Last Name
First Name
1.

Describe your experience conducting veterans or business outreach. In your description, please include the name of employer, dates of employment, your job title, and relevant job duties. If you do not have this experience, enter N/A.

2.

Describe your experience analyzing and interpreting labor market data. In your description, please include the name of employer, dates of employment, your job title, and relevant job duties. If you do not have this experience, enter N/A.

3.

Describe your supervisory experience.  Please provide name of employer, job title, dates employed, and hours worked per week.  If you do not possess this experience, enter N/A.

4.

Indicate which of the following requirements you meet.

Qualified service-connected disabled veteran.
Qualified eligible veteran.
Qualified eligible person (38 U.S.C.4101(5)).
N/A
5.

Do you have a Veterans Administration Letter of Disability Rating dated within the last six months? (If yes, please submit a copy with this application.)

Yes No

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