Department of Budget and Management

**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.**

Do you possess, or are you eligible for obtaining, certification by the Board of Professional Counselors as a Certified Supervised Counselor-Alcohol and Drug (CSC-AD)?

If you answered Yes to the previous question, please provide the license number and expiration date in the box below.  A copy of your current license or license verification should also accompany your application.

Describe your experience in fiscal support, administrative support or a related field.

This experience should be included on your application, including hours and dates worked. If you do not possess this type of experience, please put N/A in the text box.

Describe your experience with data entry and database management.

This experience should be included on your application, including hours and dates worked. If you do not possess this type of experience, please put N/A in the text box.

Describe your experience working with Electronic Health Records (EHR) Systems.

This experience should be included on your application, including hours and dates worked. If you do not possess this type of experience, please put N/A in the text box.

Describe your experience with authorization and reauthorization processes for healthcare or social services programs.

This experience should be included on your application, including hours and dates worked. If you do not possess this type of experience, please put N/A in the text box.