Official SealSan Joaquin County Human Resources Division


#0424-RH4452-PC
Supplemental Questionnaire

Last Name
First Name

 

You are applying for a position in Correctional Health Services, which provides health care to adult inmates at the San Joaquin County jail facility.

A candidate must successfully pass the security clearance, initiated through a background investigation conducted by the Sheriff’s Office. The background investigation requires the completion of an extensive questionnaire called “Personal History Questionnaire” and is used by the Sheriff’s Office to conduct the background investigation. 

The security clearance is a mandatory condition of employment, and the loss of the security clearance will result in termination from County employment in accordance with the rules and regulations governing County employment.


1.

Have you completed a recognized Pharmacy Technician training program?

Yes No
 

If yes, please identify the school or college attended, and date completed:

Note: If this does not apply to you, enter "N/A"

2.
Do you have current registration as a Pharmacy Technician issued by the State of California Board of Pharmacy?
Yes No
 
If yes, please identify the license number:
3.

One year of additional experience as a Pharmacy Technician may substitute for the education. Please provide detailed information regarding your experience as a Pharmacy Technician. Your answer must include employer name, employment dates, hours worked, and duties performed.