Official SealDepartment of Budget and Management


#21-000484-0015
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 possess a Bachelor's degree in Nursing, Social Work, Psychology, Education, Counseling or a related field?

Yes No
2

If you responded YES to the above question, what field is your Bachelor's degree in?

3

Describe your professional experience in health services.  Health services is defined as experience in areas other than Mental Health, Developmental Disabilities or Addictions.

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. 

4

Describe your experience with grants management. Please include name of employer, job title, and dates and hours worked with your description.  If you do not possess this experience, put N/A in the box below.

5

Describe your experience with grant budgets.  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.


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