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#20-000714-0004
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. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

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

Yes No
2.

Explain your professional work experience related to treatment and services to persons with alcohol or other substance use addiction.

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.

3.

Describe your experience with program implementation and data collection.

If you do not possess this type of experience, please indicate N/A in the text box.

4.

Describe your experience at the supervisory or managerial level.

Please include name of employer, job title, dates of employment, and hours worked per week. If you do not possess experience in this area, put N/A in the box below. 

5.

Describe our experience supervising professional and non-professional staff.  Include employer, job duties, dates of employment and number of hours worked per week.  Also, include title of staff you supervised.  If no experience, indicate N/A.

6.

This recruitment is limited to current State employees.  Are you a current State of Maryland employee?

Yes No

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