Official SealDepartment of Budget and Management


#17-002428-0005
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1

Do you possess a certificate of eligibility to be licensed as a Registered Environmental Health Specialist from the Maryland Board of Environmental Health Specialists?  A copy of your certificate must be attached to your application. 

Yes No
2

If you answered Yes to the above question, please provide your license number and expiration date in the space below.  If you do not possess a certificate of eligibility, please indicate N/A in the text box below.


Powered by JobAps