Official SealSan Joaquin County Human Resources Division


#0624-RS4222-01
Supplemental Questionnaire

Last Name
First Name
1.

Have you completed at least 30 semester units of social science or related work at an accredited college or university?

Yes No
 

If yes, please list:

Name of college or university
Name of courses completed and number of units (ex: Human Behavior, 3 units)

2.

Do you possess two years of experience in provision of direct client services with diverse populations, including economically disadvantaged individuals and persons with a variety of lifestyles and ethnic backgrounds, one year of which must have been included as part of an interdisciplinary team. 

Yes No
 

If you answered yes, please provide a detailed description of your qualifying experience and include:

Name of employer
Job Title
Dates of Employment
Hours Worked Per Week
Description of Duties Performed

3.

Candidates must possess and maintain a valid California driver's license.  Provide your valid California driver's license number and expiration date.