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#23-004730-0002
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.

Please list all active certifications and any degrees that you have.   If no certifications and degrees, put N/A in this section.

2.

What is your experience with regulatory and security requirements regarding specific data types including Federal Tax Information (FTI), Personally Identifiable Information (PII), Protected Health Information (PHI), Payment ward Industry (PCI), and Criminal Justice Information Systems (CJIS). If no experience in this area, put N/A in this section. 

3.

Explain your experience managing cybersecurity governance, risk, and compliance programs in a Federal, State, or Local Government organization.  Please state who you worked for and for how long.  If no experience performing these duties, put N/A in this section.

4.

Do you have experience using or developing a GRC platform or program?  If yes, please provide details about the platform or program, who you worked for and how long.  If not experience in this area, put N/A in this section.


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