Department of Budget and Management

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit.***

Do you possess a current license as a Registered Nurse from the Maryland State Board of Nursing, or a license recognized by the Multi-State Compact agreement?

Please provide your license number and expiration date in the box below.

Describe your experience providing direct support to medically underserved populations in the community and assisting them in adopting healthy behaviors.  If you do not possess this type of experience, please indicate N/A in the text box below.