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#18-002043-0024
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

Describe your administrative or professional experience.

Please include name of employer, job title, dates of employment, and hours worked per week.  This information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 

2.

Describe your supervisory experience.

Please include name of employer, job title, title(s) of those you supervised, number of employees supervised, dates of employment, and hours worked per week for each relevant position.  This information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 

3.

Describe your experience auditing fiscal and/or medical records.

With your description, include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  This experience must also be reflected in the "Work Experience" section of your application.  If you do not have this experience, put N/A in the box below.


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