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Supplemental Questionnaire

Last Name
First Name

RECRUITMENT SURVEY: Your voluntary answers to this section will assist us in evaluating our recruitment efforts. How did you hear about this position?

City & County of San Francisco's Employment website (
Received interest card email from the City & County of San Francisco
Association of Public Communications Officers (APCO)
National Emergency Numbers Association (NENA)
Personal reference - in the next section, please provide the name
Job resource or fair - in the next section, please provide the name
Other - in the next section, please provide the name of the site

If you checked any of the categories in the previous question that requests additional information, you may enter the information below.


The purpose of this Supplemental Questionnaire is to obtain specific information regarding education, training and experience as they relate to the knowledge, skills, and abilities linked to the duties of this position.  This information will be used to assist in evaluating whether you possess the skill and experience, to determine your rank on the eligible list, and will be made available to departmental personnel and management staff to assist in their hiring decisions.  The information you provide on this questionnaire should be consistent with the application and is subject to verification.


I certify that my responses to this supplemental questionnaire are true and based on my background, training, skills and experience and that I am the author of this document.  I also understand that the hiring department may require and administer additional selection devices prior to selection and during the probationary period.  Furthermore, I understand that any false or incorrect statement may result in my disqualification or dismissal from employment with the City and County of San Francisco.

Yes No

Please select the statement that best matches your highest level of education.

Bachelor's degree and/or Advanced Degree
Associate's degree
Completed some college courses at an accredited college or university
High School Diploma or equivalent (G.E.D. or California High School Proficiency Examination)

Select the statement that best matches the number of years working as a public safety (police/fire/medical) dispatcher in a multi-frequency computerized dispatch/communications center.

No experience as described above.
Less than one (1) year of experience as described above.
One (1) year but less than two (2) years of experience as described above.
Two (2) years but less than three (3) years of experience as described above.
Three (3) years or more of experience as described above.

Describe your work experience in the space provided below. If you do not possess experience as a public safety (police/fire/medical) dispatcher in a multi-frequency computerized dispatch/communications center, please enter "N/A." 

Please provide the following information:

- dates of employment

- names(s) of employer(s) where you gained the experience

- type(s) of dispatching experience (e.g. police, fire)

- type(s) of equipment used to dispatch calls


Which of the following certificate(s) do you possess?  Check all that apply.

P.O.S.T. Basic Public Safety Dispatcher
Basic Public Safety Dispatch Academy
Advanced Dispatcher
Communications Training Officer Academy (CTO)

If you possess certificates listed above, please provide the date(s) you obtained the certification. If you do not possess any certificates, enter "N/A."