Official SealDepartment of Budget and Management


#21-002293-0009
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 class A or B driver’s license, without violation?  Yes / No

If you answered No, please list in detail all violations on your driving record.

2.

Please provide the location and date for each training and safety course that you have successfully completed for each of the following: S-022; S-190 Wildlife Training Courses; S-212 Wildland Fire Chainsaw Training; Pesticide Users Safety Training. If you did not complete a particular training/safety course, please indicate this in the box below.

3.

Please describe in detail your experience in leading or supervising workers to include carrying out basic instructions. If you do not possess this experience, please indicate N/A.


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