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Human Capital Management
#170926-E55A-09


Supplemental Questionnaire

Last Name First Name
 

 

OK Department of Human Services (DHS) requires that the following questions be answered before continuing with the application.


 

Do you have legal status to work in the United States?

Yes No
 

Have you had a protective order entered against you pursuant to the Oklahoma
Protection from Domestic Abuse Act or a similar statute of another state? 

If yes, provide the name of the court and court number in the text area:

If no, please enter No in the text area:            

 

DHS policy does not allow some family members to be employed within the same supervisory group or unit. Please list the names of all of your relatives now employed by DHS:

If no, please enter No in the text area:

 

Have you ever been terminated or resigned from employment in lieu of being terminated?  
If yes, explain circumstances:      

If no, please enter No in the text area:

 

Do you have any of the following?

one year of experience in clerical office work
one year of experience as a customer service representative
thirty (30) semester hours of college, including six (6) semester hours in business or public administration
a combination of clerical office work, experience as a customer service representative AND/OR college credit hours including business or public administration coursework that totals one year
none of the above

 

ATTENTION!

 Please verify that you meet the education and experience requirements listed in the job bulletin before completing the following supplemental questionnaire. The questions below will be used for scoring purposes, in lieu of a written exam.


 

Please check the box that represents your highest level of education.

I have an Associate's degree or higher.
I have completed some college courses but do not have a degree.
I have none of the education listed above.
 

Please list the college or university where you gained your education as indicated in the response above.  If you indicated "no education", then please type N/A below. 

 

What experience do you have researching and gathering information?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

Please check all of the following computer programs you have experience using.

Microsoft Word or similar word processing software
Microsoft Excel or similar spreadsheet software
Microsoft Outlook or similar email program
I have no experience with any of the above.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have using a computer to gather information and draft written documents?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

 

What experience do you have interpreting and implementing policies and procedures?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have preparing and giving verbal presentations?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have planning, developing and organizing all phases of your own work?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have in mediation or conflict resolution with the public?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What is your highest level of experience in working as part of a team?

I have led a team or group project.
I have been a member of a team or group project.
I have never been a part of a team or group project.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What is your experience providing customer service to the public?

I have performed this task on a daily basis.
I have performed this task on a weekly basis.
I have rarely performed this task.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have reading and interpreting detailed instructions?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have teaching others new material?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have preparing written reports?

I have written reports as a regular part of my job. My work was not subject to supervisor review.
I have written reports as a regular part of my job. My work was subject to supervisor review.
I have written reports for a college course.
I am familiar with this task or have received some training on it.
I have no experience with report writing.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have conducting multiple tasks simultaneously and meeting firm deadlines for those tasks?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below.