Official SealHuman Resource Services Department


#14-5305-01
Supplemental Questionnaire

Last Name
First Name

 

IMPORTANT:  Applicants for this position are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process. Additionally, your responses will also be evaluated and used in the selection process in order to identify the best qualified applicants.  Responses should be thorough and specific.  A lack of detail and explanation in the supplemental questions and in your application may result in failure or disqualification for this position.  Clarity of expression, content, experience, grammar, spelling and the ability to follow instructions will be considered in the evaluation process.  A resume will not be accepted as a substitute for properly completed responses.


1
Do you possess any state license(s), certificate(s) and/or registration(s)  which qualify you for the position. Indicate serial number, date issued, expiration date for each.
2
Do you have additional job-related training and/or education beyond that required by the minimum qualifications?

If yes, indicate additional training/education.
3

To claim veterans’ preference points, attach a copy of honorable discharge (DD-214). If you claim service-connected disability, also attach proof from the Veteran’s Administration of current disability of 10% or more.
Do you claim veterans’ preference points?

Yes No
4
Do you claim veterans’ service connected disability?
Yes No

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