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Supplemental Questionnaire

Last Name
First Name

 

Supplemental Questionnaire


INSTRUCTIONS: Completion of this supplemental questionnaire is REQUIRED. Please read each question carefully and provide clear and complete responses that accurately portray your education and relevant work experience. Your qualifications for employment will be evaluated based upon the information you provide in your responses below and then verified by our staff who will review your entire application for completeness and determine qualification status.

The employers and dates of employment that you list on this supplemental questionnaire MUST match the employers and dates of employment provided in the work experience section of your employment application. Failure to provide matching employer, and dates of employment may result in your application being "not qualified" for this recruitment.

IMPORTANT NOTE: "See Resume" is not an acceptable response to any of the open-ended questions on this questionnaire and will result in your application being "not qualified" for this recruitment.



 

Do you possess a minimum of a High School Diploma/GED?

Yes No
 

Do you possess a Child Development Associate (CDA) and/or National CDA from the Council for Professional Recognition in preschool endorsement, and an Associate’s degree or higher in early Childhood Development or a related field with 18 credit hours in Early Childhood Education? 

Yes No
 

Do you have 40 clock hours from the Florida Department of Children and Families?

 

Yes No
 

Do you have at least 2 years of experience working with Head Start, pre-school, or kindergarten aged children? (Years of experience are based on Full Time work schedule; i.e. 40 or more hours per week).

Yes No
 

Please provide a narrative supporting your answer to the above question.  Be sure to include the specific job title, job duties, and the organization and dates where the work was performed.

 

Do you have knowledge and experience with the basic principles of child development?  Any experience indicated here must be reflected in your work history.

Yes No
 

Please provide a narrative supporting your answer to the above question.  Be sure to include the specific job title, job duties, and the organization and dates where the work was performed.

 

Do you have experience successfully working with a culturally diverse staff and clients?

Yes No
 

Please provide a narrative supporting your answer to the above question.  Be sure to include the specific job title, job duties, and the organization and dates where the work was performed.

 

Are you a past Head Start student or a past or current Head Start parent?

Yes No
 

Have you ever been employed by Hillsborough County Head Start/Early Head Start Program or any of its delegates or contracted sites? 

Yes No
 

If so, please list the name of the program for which you worked and the dates of employment.

 

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By checking the box above, I certify that all of my responses are true and complete, and any misstatement of material facts OR failure to completely answer questions or provide my employer with a copy of any licenses, certifications, or other documents listed on the job announcement will subject me to disqualification from the application process and/or dismissal from employment.

I also authorize investigation of all statements contained in my application, to include a formal background check that may require education and employment verification; criminal history; and motor vehicle driving report as may be necessary in arriving at an employment decision. Further, I acknowledge understanding that an offer of employment will be subject to successfully passing a drug screen and physical.

I also understand that once I submit my application for this recruitment, I cannot edit it later.