Official SealSan Joaquin County Human Resources Division


#0124-RH0223-AC
Supplemental Questionnaire

Last Name
First Name
1

Do you possess a bachelor's degree from an accredited college or university with major in public administration, business administration, health care administration, or a closely related field? 

Yes No
1a

If yes, please provide the name of the college/university you attended and the area you received your Bachelor's Degree.

2

This position requires one year administrative experience in emergency medical services systems and programs. 

Substitution: Additional direct administrative experience in emergency medical services systems and programs may substitute for the education on a year for year basis to a maximum of two years.

Please detail the relevant experience you possess in the space provided below.  Be sure to include the name of the employer, job title, dates of employment, along with the typical duties you performed.

3

Do you possess a valid California drivers license?

Yes No
3a

If you answered "Yes" to Question No. 1, please provide your valid California drivers license number and expiration date.