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#19-005477-0026
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.***


1

Do you have three years of experience working on the development and implementation of policies related to homelessness on the federal, state, or local level? If so, please provide sufficient details to evaluate this experience, and include employer names and dates of employment. If you do not have this experience, enter N/A.

2

Do you have knowledge of and experience with issues relating to homelessness and or self-sufficiency programs?  If so, please describhow your knowledge and experience was gained, including employer names and dates of employment. If you do not have this experience, enter N/A.

3

Do you have knowledge of and experience with nonprofit organizations, foundations or government program administration? Y/N. If yes, please provide sufficient details to evaluate this experience, and include employer names and dates of employment. If you do not have this experience, enter N/A.


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