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#24-002596-0001
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 at least two years of experience providing case management services to emotionally or socially maladjusted, delinquent, victimized, or exceptional juveniles in a community or residential setting? Include in your response the employer name(s), hours worked, and dates of employment, and describe the types of services you provided. If you do not possess this experience, please indicate N/A.

2.

Describe your experience or knowledge of public and private resources that address DJS juvenile service needs. Include in your response the employer name(s), hours worked, and dates of employment, and list some of the resources that address the needs of juveniles. If you do not possess this experience, please indicate N/A.

3.

Describe your experience and level of participation with the DJS placement process. Include in your response the employer name(s), hours worked, and dates of employment. If you do not possess this experience, please indicate N/A.

4.

Do you have experience with ASSIST database? Include in your response the employer name(s), hours worked, and dates of employment. If you do not possess this experience, please indicate N/A.


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