San Joaquin County Human Resources Division

#1123-RB4003-SR
Supplemental Questionnaire

Last Name
First Name

PATTERN I

Do you have two years of experience as an Accountant II employed by San Joaquin County?

Yes No

PATTERN II

I have graduated from an accredited four-year college or university with major coursework in the following field:

Business Administration

Accounting

Economics

Other

If you answered "other," please provide your major:

Please list at least 12 semester units of completed coursework in accounting.

Include the following information for EACH course:

Do you have at least 3 years of full-time paid professional accounting experience?

Yes No

Please list at least 15 semester units of completed coursework in accounting.

Include the following information for EACH course:

PATTERN III

Have you completed at least 60 semester units from an accredited college or university?

Yes No

Do you have at least 5 years of full-time paid professional accounting experience?

Yes No

FOR ALL PATTERNS

Please provide your California Driver's License number AND expiration date.

Do you have at least one year of experience performing complex accounting in a health care environment?

Yes No

Please describe your health care accounting experience with the following tasks:

Please indicate if you have accounting experience with the following:

Non Profit Organization

Federally Qualified Health Center (FQHC)