**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 current license as Dietitian/Nutritionist from the Maryland Board of Dietetic Practice?
Yes
No
2.
If yes, please provide your license type, license number and expiration date below.
3.
Describe your experience working with a nutrition or dietetic program or service. Please include name of employer(s), job title(s), dates of employment, and hours worked. If this does not apply to you, enter N/A in the box below.
Department of Budget and Management