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#26-005477-0015
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 at least three years of professional experience working directly with Child Welfare or Adult Services programs with a working knowledge of Title IV-E regulations? Please indicate *Yes* or *No*. If yes, please provide the position title, a description of job duties, and the dates of employment (from and to).

2.

Do you have at least 3 years of professional experience leading large-scale planning projects or workgroups involving multiple internal and external stakeholders (e.g., LDSS Directors, Attorney General's Office, Office of Government Affairs)? Please indicate *Yes* or *No*. If yes, please provide the position title, a description of job duties, and the dates of employment (from and to).


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