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#0724-RM0226-DP
Supplemental Questionnaire

Last Name
First Name
1.

Have you graduated  from an accredited four year college or university with a major in public or business administration, economics, social or behavioral science, or a closely related field?

Yes No
 

If you answered yes to the previous question, please provide the following information: Degree type (BS, BA, etc), discipline/emphasis, and school attended. (Example: BS, Public Administration, ABC University)

2.

This position requires at least three years of full-time, responsible managerial and/or administrative analytical work experience. 

Please provide information regarding your qualifying work experience. 

For all positions, include: 

  • Name of employer
  • Job Title
  • Dates of employment
  • A detailed description of the specific job duties performed
3.

Based on your answer to Question No. 2, please provide a detailed description of your relevant analytical work experience. 

For all positions provide:

  • Name of Employer
  • Job title
  • Dates of employment
  • Detailed description of specific job duties

 

4a.

Provide a description of your administrative or analytical managerial work experience.

4b.

Provide a description of your administrative or analytical fiscal work experience.

4c.

Provide a description of your administrative or analytical personnel work experience.

4d.

Provide a description of your experience with facilities management, program development and/or grant writing and monitoring.  

Please include:

Name of employer
Job Title
Dates of employment
Detailed description of the specific duties you performed in these areas. 

If no specific experience, please say "None"

5.

Substitution: A Master's Degree in public or business administration, economics, or a closely related field from an accredited college or university may be substituted for one year of experience.

If using the substitution, please list the university name and degree awarded:

6.

This is a departmental promotion.  Qualifying candidates must be currently employed with HSA.  Please provide your employee ID.