Official SealSan Joaquin County Human Resources Division


#0225-RH2501-PC
Supplemental Questionnaire

Last Name
First Name
 

Do you possess a valid California license as a Psychiatric Technician issued by the Board of Vocational Nurse and Psychiatric Technician examiners of the State of California?
Yes No
 

Please provide your Psychiatric Technician number issued by the Board of Vocational Nurse and Psychiatric Technician examiners of the State of California.