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Human Capital Management
#170915-UNCY-125


Supplemental Questionnaire

Last Name First Name
 
1.

Please select the option that describes your current or most recent employment status with the State of Oklahoma.

Current OSDH employee
Current employee of another State of Oklahoma agency (not OSDH)
Former employee of OSDH or another state
None of the above
2.

If you indicated that you worked at another State of Oklahoma agency, please type the name of that agency in the box.  If you worked at OSDH, please type OSDH in the box.

3.

If you are a previous or current State of Oklahoma employee and know your “PeopleSoft employee ID” number, please provide it.

If no, please indicate N/A in the text area.

4.

Are you legally able to work in the United States?

Yes No
5.

OSDH policy prohibits employment in positions that result in the immediate supervision by a relative or in a position resulting in relatives occupying a supervisory position in the chain of command regarding another relative.   Relatives are defined as spouse, child, parent, sibling, aunt, uncle, niece, nephew, or first cousin to include any in-law, foster, step, half, and grand relationships; or any person with whom the employee has a domestic relationship. Please list the names of all of your relatives now employed by OSDH:

If no, please indicated N/A in the text area.