Official SealSan Joaquin County Human Resources Division


#1224-RH8002-PC
Supplemental Questionnaire

Last Name
First Name
1.
Have you graduated from an accredited college or university with major course work in dietetics, nutrition, or a closely related field including or supplemented by the completion of a dietary internship at an approved institution?
Yes No
 

If yes, please specify:

 

  • name of program/school:
  • start of program/school:
  • date of program completion: 
  • date certificate/degree received:
2.
Do you have two years of professional dietetics work experience, including a minimum of one year in an institutional setting.
Yes No

 

If you answered yes to question #2, please ensure all professional Dietetic experience is included in the employment history section of your application. 
3.
Do you possess current registration as a Dietitian with the American Dietetic Association?
Yes No
 
If yes, please enter your RD registration number below: