Official SealDepartment of Budget and Management


#19-002942-0001
Supplemental Questionnaire

Last Name
First Name

 

Below you will find supplemental questions relating specifically to this position.  These questions provide the hiring manager with details regarding your education and experience that relate specifically to duties of the position.  Applications that do not include a completed supplemental questionnaire, or refer the reviewer to the application form/attachments, may be considered incomplete and could be subject to disapproval.

Answers received on the supplemental questionnaire must correspond to the information provided on the application, including name of employer, dates of employment, and hours worked per week.  


1

Do you possess a Bachelor's degree in Nursing, Social Work, Psychology, Education, Counseling or a related field?

Yes No
2

What is the major field of study for your bachelor's degree? If you answered "No" to the previous question, please enter N/A in the box.

3

Describe your professional experience in health services.  Health services is defined as experience in areas other than Mental Health, Developmental Disabilities or Addictions.

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 at the managerial and/or supervisory level, especially in a Psychiatric setting.

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 professional experience with cancer prevention and control.

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.

6

Describe your experience managing contracts with partners in health systems, local health departments and community organizations.  This experience must also be included on your application.  If you do not possess this type of experience, please indicate N/A in the text box below.

7

Please describe your Microsoft Office Suite experience and proficiency in details. Please give examples of the Microsoft application used along with the documents created.  Include in your answer employer name(s) and dates of employment.  If you do not possess this experience, enter N/A.


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