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#17-002598-0007
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 have at least three years of experience providing case management or resource specialist services to emotionally or socially maladjusted, delinquent, victimized or exceptional juveniles in a community or residential setting. Also, identify from your application where you gained this experience. If you do not have this experience, please enter N/A.

2.

In the space below describe your experience partnering and coordinating juvenile services with community- based programs, services and treatment plans including juvenile justice agency officials, the juvenile court, prosecutors and defenders to address strategies to reduce racial disparities in the juvenile justice system. 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.

3.

Describe your experience developing and facilitating training on juvenile justice topics including community and/or family engagement. 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

4.

Describe your experience with use of juvenile justice and/or public safety data/information to guide your decision making and insight regarding juvenile justice programming. 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


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