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#17-001797-0011
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 three years experience in food preparation at a public or government establishment, such as a restaurant or hospital involving the cooking of meats and vegetables and the preparation of salads and beverages?

Yes No
2.

If you answered "Yes" to the previous question, please describe this experience in the field below. What was your job title in performing these duties and list the name of the employer, employment dates, and hours worked per week.  If you do not have this experience, please enter N/A.


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