Official SealDepartment of Budget and Management


#17-004404-0001
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.***


1.

Do you possess a Bachelor's degree from an accredited college or university, with thirty credits in Behavioral Science, Health Services, Human Services or Education?

Yes No
2.
If yes, please list the required coursework (thirty credits in Behavioral Science, Health Services, Human Services or Education) in the space below using the following format.  You must also attach a copy of your official or unofficial transcripts to your application:
 
Example:  Course Number   Title                                    Credits Earned
                     BIO 101           Introduction to Biology                     3.0 
 
*This information will be verified upon employment.  
3.

In the box below, please specify your degree (level/field).  For example, a bachelor's degree in Business.

4.

Describe your experience managing or directing alcohol and other drug prevention services in a community and/or school setting.

Please include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  If you do not have this experience, put N/A in the space below.

5.

Describe your professional work experience with grants and/or budget management. 

Please include name of employer, job title, dates of employment, and hours worked per week.  This information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

6.

Please describe your supervisory experience.  Include employer name(s), job title(s), dates of employment, and titles of those you supervised.  If you do not possess this experience, enter N/A.


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