Official SealDepartment of Budget and Management

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.***


Please explain in detail your work experience in the construction, installation, repair, adjustment or inspection of elevators, escalators, moving walks, lifts, hoists or other related devices. If no, indicate N/A


Describe in detail any investigative and report writing experience you possess; provide two examples of your report writing ability/experience. If no, indicate N/A.


Do you have a Qualified Elevator Inspector (QEI) certification and/or are you a licensed elevator mechanic? If yes, please indicate certificate or license. If no, indicate N/A.


Do you possess a valid driver's license? Do you have reliable transportation, available to you at all times?

Yes No

Please detail your level of computer/tablet experience.

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