**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
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?
Yes
No
2
If you responded YES to the above question, please provide your license number and expiration date in the text box below.
3
Describe your knowledge of and experience with COMAR Regulations. This experience must also be included in your application. If you do not possess this type of experience, please indicate N/A in the text box.
4
Describe your knowledge of and experience with nursing standards of practice. This experience must also be included in your application. If you do not possess this type of experience, please indicate N/A in the text box.
5
Describe your knowledge of and experience with quality enhancement and health care trends. This experience must also be included in your application. If you do not possess this type of experience, please indicate N/A in the text box.
6
Describe your knowledge of and experience with DDA Waiver requirements. This experience must also be included in your application. If you do not possess this type of experience, please indicate N/A in the text box.
Department of Budget and Management