Department of Budget and Management

**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.**

Do you possess a current license as a Physical Therapist from the Maryland State Board of Physical Therapy Examiners?

If you answered Yes to the previous question, please provide the license number and expiration date in the box below.  A copy of your current license or license verification should also accompany your application.

Describe your experience as a Physical Therapist.

Include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  This experience must be reflected in your application.  If you do not have this experience, put N/A in the box below.