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Human Capital Management
#171003-L20A-01


Supplemental Questionnaire

Last Name First Name
 
 

Do you have any of the following?

six (6) months of experience as a communications dispatcher
fifteen (15) semester hours of college coursework
none of the above

 
STOP! You have completed the required screening questions for this Job Family.  Please verify 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 in lieu of a written exam.

1.
Check the box that represents your experience dispatching emergency response or fire suppression resources.
I have more than one year of experience.
I have six months to one year of experience.
I have less than six months of experience.
I have received some training on it.
I have no dispatching experience or training.
 
Please list the training institution 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. 
2.
Check the box that represents your highest level of education attained.
I have more than 15 hours of education from an accredited college or university.
I have 1 to 15 hours of education from an accredited college or university.
I have no hours of education from an accredited college or university.
 
Please list the name of the institution where you gained your education.
3.
What experience do you have in locating residences on a County 911 map?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
4.
What experience do you have in converting a location given in latitude/longitude coordinates to Section-Township-Range?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
5.
What experience do you have locating the closest available resources to an emergency using a dispatch map?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
6.
What experience do you have in verifying map locations on various Geographical Information Systems (GIS)-layers?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
7.
What experience do you have in entering information into database software?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
8.
What experience do you have entering information into spreadsheet software?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
9.
What experience do you have in gathering data, interpreting data, and writing reports?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
10.
Check all of the following certifications or training courses you have satisfactorily completed (check all that apply).
IS-100.a-Introduction to the Incident Command System
IS-200.a-ICS for Single Resources and Initial Actions Incidents
IS-700.a-National Incident Management System (NIMS), an Introduction
IS-800.b-National Response Framework
National Wildlife Coordinating Group (NWCG) S-190 Introduction to Wildland Fire Behavior.
Association of Public-Safety Communications Officials (APCO) Institute's Fire Service Communications, 1st Edition
I have completed none of the above certifications or training courses
11.
What experience do you have in conducting and maintaining an accurate inventory of accountable property, including supplies, materials, and firefighting equipment?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
12.
What experience do you have in interpreting and relaying critical information such as changes in weather to emergency response personnel?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
13.
What experience do you have in determining a location's Section-Township-Range on a map?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
14.
What experience do you have in receiving emergency telephone calls from the public?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I have no experience with this task.
 
Please list the training institution 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. 
15.
What experience do you have in performing calculations using Microsoft Excel or similar spreadsheet software?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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. 
16.
What experience do you have in speaking to the public about fire safety and prevention?
I have performed this task independently as a regular part of my job.
I have performed this task as a regular part of my job with some supervision.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the training institution 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.