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#21-001052-0001
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.

Describe your experience with GIS and creating maps from field data. Include name of employer, job title and dates employed. If you do not have this experience, enter N/A.

2.

Describe your experience with report writing. Include name of employer, job title and dates employed. If you do not have this experience, enter N/A.

3.

Describe your experience with field and laboratory equipment related to hydrogeology (e.g, scientific, survey and sampling devices and equipment such as water quality meters, titration kits, water-level meters, pressure transducers, etc). Include name of employer, job title and dates employed. If you do not have this experience, enter N/A.

4.

List all completed coursework or work experience related to groundwater and/or water chemistry. If you do not have this coursework or experience, enter N/A.


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