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#26-002144-0002
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 have one (1) year of experience providing services to veterans and their dependents?

Please note this experience must correspond with the experience on your application. 

Yes No
2.

Please describe your experience in claims processing veterans, their dependents and families regarding their benefits, services, medical care and pension. 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.

3.

Please describe your experience and knowledge of State, Federal and Local laws concerning the benefits, privileges and obligations to veterans and their families. Please include employer name, dates of employment, and job duties in your description. If you do not have this experience please enter N/A.


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