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#17-002344-0009
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 in Nursing, Social Work, Psychology, Education, Counseling or a related field?

Yes No
2.

Do you possess a Master's degree in health or human services?

Yes No
3.

Describe your professional experience related to the treatment and services for mentally ill patients. 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 professional work experience in the provision of services in the Public Behavioral Health 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.

5.

Please describe experience in which you were required to use excellent time management and organizational skills.

6.

Please describe experience in which you had to utilize written and oral communication skills.

7.

Do you have experience using Microsoft Office Suite (Word, Excel, Access or Outlook)?  If YES, please describe this experience and include job title, dates of employment and hours worked per week (this information must also be reflected in your application). If you do not have this experience, please indicate N/A in the box below.

8.

Describe your familiarity with Google Apps (G-Mail, Google Sheets, Google Docs). 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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