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#17-002611-0002
Supplemental Questionnaire

Last Name
First Name
1

Please describe your experience with planning and supervising the performance of employees' work and provide the dates of employment and the name of the employer where you performed this responsibility.  (If you do not possess this experience, enter N/A.)

2

Please describe your experience with planning and supervising the performance of employees' work within a secure juvenile residential setting and provide the dates of employment and the name of the employer where you performed this responsibility. (If you do not possess this experience, enter N/A.)


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