Official SealDepartment of Budget and Management

Supplemental Questionnaire

Last Name
First Name

Are you currently licensed as an LCSW-C in Maryland? If not, please list when you anticipate being eligible for LCSW-C licensure and what requirements are still outstanding. Or indicate when you submitted your application to Maryland Board of Social Work Examiners for out of state approval of your LCSW-C


Please rank and list your soft skills from strongest to weakest.


 Briefly describe your interest in working on behalf of parents whose children have been removed by DSS.

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