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#19-009606-0001
Supplemental Questionnaire

Last Name
First Name

 

Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.


1

Do you possess a bachelor's degree from an accredited college or university in business, communications, or a mathematics related major?  If so, please indicate field of study in the box below.  If no, please write N/A.

2

In which field of study is your degree? If you do not have a degree, enter N/A.

3

Describe your executive level health services 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.

4

Describe your experience working with medical care.

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.

5

Describe your experience in health services at a management or supervisory level.

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.


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