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#TEX-7338-104080
Supplemental Questionnaire

Last Name
First Name
 

SUPPLEMENTAL QUESTIONNAIRE

The purpose of this Supplemental Questionnaire is to determine your knowledge, skills, and abilities in job-related areas that have been identified as critical for satisfactory performance in this position. All relevant experience, education and/or training must be on the supplemental questionnaire in order to be reviewed.  This information should be consistent with the information on your application (employment record, resume) and is subject to verification. The hiring department may review this information as part of their selection process.

Please be thorough and concise.  All of your information MUST be supplied in the spaces provided. Attachments or additional documents such as resumes, cover letters, or application will NOT be considered. (i.e. Writing “see resume/website/application” or “N/A” is not sufficient response.)

CERTIFICATION:  I hereby certify that I am the author of this supplemental questionnaire and that all information presented is true and based on my education and experience and is consistent with the information in my employment application. I understand that any false, incomplete or incorrect statement may result in my disqualification or dismissal from employment with the City and County of San Francisco. I also understand and agree that any information provided is subject to verification.

Yes No
1.

I have completed a State Certified electrical line apprenticeship program.

Yes
No
2.

Select the statement that best matches the number of years of experience as a journey-level line worker working with pole systems, construction, installation, maintenance and repair of overhead lines, communication systems and underground communication systems.

I possess 1 year - 1 year 11 months of experience as described above
I possess 2 years - 2 years and 11 months of experience as described above
I possess 3 years and more of experience as described above
I possess less than 1 year of experience as described above
I do not possess this experience
3.

Do you possess a valid Class A or Class B driver license?

I possess a valid Class A California Driver License
I possess a valid Class B California Driver License
I possess a valid Class A Driver License issued outside of State of California
I possess a valid Class B Driver License issued outside of State of California
I do not possess a valid class A or class B driver license
4.

I have completed a Lineman college program with a minimum of 500 hours of which at least 375 hours be field training that includes pole climbing.

Yes
No
5.

Do you possess a valid Pole Climbing Certificate?

Yes
No