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. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

Do you possess a current license as a Dietitian or Nutritionist from the Maryland State Board of Dietetic Practice? If YES please include your license number and expiration date in text box.  Also, please upload copy of license to your application.

Please describe your experience providing professional nutrition or dietetic services within a public health or community setting.  This experience must also be included in your application.  If do not possess this type of experience, please indicate N/A in the text box.

Please describe in the box below your professional experience with the Maryland WIC Program.  Please include name of employer(s), job title(s), dates of employment, and hours worked.  If this does not applly to you, enter N/A in the box below.

Please describe your supervisory experience.  Include employer name(s), job title(s), dates of employment, and titles of those you supervised.  If you do not possess this experience, enter N/A.