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#CBT-6120-093871
Supplemental Questionnaire

Last Name
First Name

 

Introduction:

 

The purpose of this supplemental questionnaire is to assist in determining if you meet the specified Minimum Qualifications of class 6120 Environmental Health Inspector – Consumer Protection Program specialty. All applicants are required to complete this supplemental questionnaire as part of the online application process. The information you provide should be consistent with the information listed on your online application. The supplemental questionnaire does not substitute for the online application. All statements are subject to verification.


1

EDUCATION:

As a reminder, all education must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the education you are about to describe in the Education section of your application, you will not receive credit for this experience.  If you are copying an old application, please take the time to update your Education before submitting your application.

Please indicate the degree you possess from an accredited college or university that is relevant to the Environmental Health Inspector class requirement

Associate Degree
Bachelor of Arts Degree
Bachelor of Science Degree
Masters of Arts Degree
Masters of Science Degree
Doctor of Philosophy Degree
Juris Doctorate
I do not possess a degree
 

Please indicate what the subject area your degree in Question #1 was conferred for:

Engineering
Environmental Health
Mathematics
Physical Science
Natural Science
Biological Science
None of the above
2

LICENSES:

I have a valid REHS (Registered Environmental Health Specialist) certification issued by the State of California, Department of Public Health Services.

Yes No
 

Tell us when this REHS certification will expire. Type N/A if this does NOT apply to you.

3

Do you possess a valid California’s Driver License, Class C type?

Yes No
 

Do you possess a valid Driver’s License from another state, and would be able to obtain a California license, if selected in an appointment?

Yes
No
Not applicable to me as I have a California Driver's License
 

CERTIFICATION: By checking this box, I hereby certify that I am the author of the information supplied in this supplemental questionnaire.  I understand that any false or incorrect statements may result in my disqualification or dismissal from employment with the San Francisco Department of Public Health and City and County of San Francisco.  I also understand and agree that the information provided is subject to verification.