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#TEX-2591-079619
Supplemental Questionnaire

Last Name
First Name

 

2591 Health Program Coordinator II
(TEX-2591-079619)

Supplemental Questionnaire

 

All applicants are required to complete the Supplemental Questionnaire (SQ) as part of the online application process.  The purpose of the Supplemental Questionnaire is to determine whether applicants possess the minimum qualifications for the 2591 Health Program Coordinator II position.  This information should be consistent with your application (i.e., must be included in the Education and Training and Employment Record sections) and is subject to verification.


1a.

Select the statement that best matches the level of education you have completed. (One year is equivalent to 30 semester units/45 quarter units.)

No formal college education
Compleion of one (1) year of college education
Possession of an Associate's Degree from an accredited college or university or completion of two (2) years of college education
Completion of three (3) years of college education
Possession of a Bachelor's Degree from an accredited college or university
Possession of a Master's Degree or higher from an accredited college or university
2a.

How many months of verifiable full-time equivalent administrative or management experience do you have where your primary responsibilities include overseeing, monitoring, or coordinating a program providing health and/or human services? (Full-time is equivalent to 40 hours per week.)

Less than 12 months
12 to 23 months
24 to 35 months
36 to 47 months
48 to 59 months
60 to 71 months
72 or more months
2b.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable full-time equivalent professional work experience as indicated in Question #2a.

In addition, 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 selected that you do not have experience, please type "N/A" in the box below.

Do not type “See Resume.”


 

The remaining questions are used to assess whether applicants have the desired qualifications for the 2591 Health Program Coordinator II (Exercise and Quality Improvement Coordinator) position. This information will only be used by hiring managers to determine those applicants that most closely meet the needs of the Department.


3a.

Do you possess a Master's degree in Public Health or related field?

Yes No
3b.

Please list the school where you obtained your Master's degree as well as the field of study (e.g. Master's degree in Public Health from San Francisco State University). If you do not have a Master's degree, please type "N/A" in the box below.

4.

Do you possess Homeland Security Exercise and Evaluation Program (HSEEP) certification?

Yes No
5a.

Please describe your experience in designing and/or conducting emergency preparedness exercises.

5b.

Please provide the name of the employer(s) and the dates of employment (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable work experience as indicated in Question #5a.

In addition, 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 selected that you do not have experience, please type "N/A" in the box below.

Do not type “See Resume.”

6a.

Please describe your knowledge of public health preparedness concepts (e.g., Incident Command System).

6b.

Please provide the name of the organization(s) or employer(s) and the dates (e.g. MM/YYYY – MM/YYYY) where you obtained your knowledge as indicated in Question #6a.

In addition, please list the name of (a) instructor(s) or supervisor(s) or who can verify the information provided as well as his or her contact information. If you indicated that you do not have any knowledge, please type "N/A" in the box below.

Do not type “See Resume.”

 

CERTIFICATION: I hereby certify that all information is true and based on my education, training, skills, and experience. I understand that any false or incorrect statement may result in my disqualification of the selection process for this position and/or dismissal from employment with the City and County of San Francisco. I also understand and agree that any information provided is subject to verification.