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 from the Maryland State Board of Examiners for Speech-Language Pathologists or the Maryland State Board of Examiners for Audiologists?  If you respond yes to this question, please upload a copy of your license to your application.

Do you possess a Certificate of Clinical Competence in Speech-Language Pathology or Audiology?  If you respond yes to this question, please upload a copy of your certificate to your application.

Describe your experience as a Speech-Language Pathologist or Audiologist.

Please include name of employer, job title, dates of employment, and hours worked per week for each relevant position.  If you do not have this experience, put N/A in the space below.