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#24-002420-0001
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

Do you possess a Bachelor's degree from an accredited college or university?

Yes No
2

Do you possess a Master's Degree from an accredited college or university?

Yes No
3

What field of study is your master's degree in?

4

Describe your experience evaluating, analyzing, researching and developing health care services, policies, and programs.

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

5

Describe your experience in the field of Public Health, including familiarity with public health principles, practices, and protocols. 

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.

6

Describe your experience in program development, implementation, and evaluation within the realm of public health initiatives, involving a proven track record of successfully managing and executing health-related programs.

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.

7

Describe your experience working effectively within committees, task forces, or similar collaborative groups focused on public health initiatives, including the ability to contribute meaningfully to discussions, facilitate decision-making processes, and coordinate efforts among diverse stakeholders.

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.


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