Official SealDepartment of Budget and Management


#21-005165-0034
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 experience providing career counseling and case management?  If yes, 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 no, indicate N/A. 

2.

Describe your experience in vocational rehabilitation and/or other human services related field.  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 no experience, indicate N/A.

 

3.

Do you have experience facilitating group instruction and interacting with consumers in a group setting? Please include name of employer, job title, dates of employment, and hours worked per week, this information also be reflected in your applications.  If you do not possess experience in this area, put N/A in the box below.

 

4.

Do have experience preparing others for employment using job seeking tools and resources?  If yes, 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 no experience, indicate N/A.

 

5.

Do you have professional experience working with individuals with disabilities? If yes, 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 no experience, indicate N/A.

 


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