Official SealSan Joaquin County Human Resources Division


#1121-RH2002-01
Supplemental Questionnaire

Last Name
First Name
1.

Do you have a valid license as a Vocational Nurse issued by the State of California Board of Vocational Nurse and Psychiatric Technician Examiners?
Yes No
 

If you answered yes, please provide the following:

  • Valid Vocational Nurse license number
  • Date of Expiration
2.

Do you possess five years of clinical experience as a Licensed Vocational Nurse in an acute care hospital? (Please note specialty clinic that are a part of an acute care hospital will be accepted.)
Yes No
 

If you answered yes to Question No. 2, please describe your experience in an acute care hospital and/or ambulatory care setting.
 

This position requires satisfactory completion of fifteen (15) continuing education units in area of specialization within the twelve (12) months immediately preceding date of application. 

Please list completed courses with the amount of units and dates of completion. 
 

Please select which department you are interested in being referred for hiring consideration:
San Joaquin General Hospital
San Joaquin County Clinics