Official SealDepartment of Budget and Management


#22-005213-0001
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.

Are you fluent in American Sign Language (ASL)?

Yes No
2.

Do you have experience working with young children in a school or hospital setting?

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.

3.

Please explain your experience in school or community nursing. Please include the name of employer(s) and dates of employment when you performed these duties. If you do not have this experience, please write N/A.


Powered by JobAps