0941 MANAGER VI – ZSFG DIRECTOR OF PHARMACY (PBT-0941-0989103)
SUPPLEMENTAL QUESTIONNAIRE
PLEASE READ THE FOLLOWING INSTRUCTIONS CAREFULLY
The purpose of the Supplemental Questionnaire is to assist with determining if you possess the Minimum Qualifications for the 0941 Manager VI – ZSFG Director of Pharmacy position.
It is suggested that you allow ample time to submit your application and Supplemental Questionnaire responses before the filing deadline. If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with the information on your employment application and are subject to verification.
1.
Please select the highest level of education that you have completed.
High School Diploma or equivalent
Associate's degree
Bachelor's degree
Master's degree
Doctoral degree
None of the above
Please list the school(s) where you obtained your degree(s), the discipline/field of study, and type of degree earned (e.g. Bachelor of Arts degree in Psychology from the San Jose State University). If you do not possess any of the degrees identified above, type N/A.
2.
Do you have a valid license as a Registered Pharmacist issued by the California State Board of Pharmacy?
Yes
No
If you answered that you possess a valid license in #2 above, please identify your license number, your name as it appears on your license, and the expiration date of your license. If you do not possess a license as identified above, type N/A.
3a.
How much pharmacy management experience do you have?
One (1) year of full-time experience is equivalent to 2,000 hours.
I have less than one (1) year of experience
I have at least one (1) year, but less than two (2) years of experience
I have at least two (2) years, but less than three (3) years of experience
I have at least three (3) years, but less than four (4) years of experience
I have at least four (4) years, but less than five (5) years of experience
I have five (5) years of experience or more
I do not have any experience
3b.
How much of the pharmacy management experience in 3a above included experience supervising licensed Pharmacists?
One (1) year of full-time experience is equivalent to 2,000 hours.
I have less than one (1) year of experience
I have at least one (1) year, but less than two (2) years of experience
I have at least two (2) years, but less than three (3) years of experience
I have at least three (3) years, but less than four (4) years of experience
I have at least four (4) years, but less than five (5) years years of experience
I have five (5) years of experience or more
I do not have any experience
In accordance with your responses to #3a and #3b above, please provide the name of the employer(s) and the dates (e.g. MM/YYYY – MM/YYYY) where you obtained the verifiable full-time equivalent work experience.
Additionally, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you do not have experience in these areas, please type N/A.
I understand that checking this box will serve as my electronic signature. I certify that I am the author of this questionnaire and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.
Department of Human Resources