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#21-002823-0010
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 have a High School Diploma?

Yes No
2.

Do you possess a Trade Certificate in the trades of electricity, plumbing, HVAC, painting, carpentry, or ground maintenance. If so, please specify. If you do not possess a trade certificate in any of the above trades, please type N/A.

3.

Please describe your experience installing light fixtures, outlets, transformers, troubleshooting, and testing electrical components by applying appropriate electrical theories, principles, and codes to address specific electrical problems. Please include the name of the 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, type N/A


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