Official SealDepartment of Budget and Management


#17-004304-0004
Supplemental Questionnaire

Last Name
First Name

 

Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.


1

Do you currently possess a license as an Occupational Therapist in Maryland?  If yes, please attach a copy to your application.

Yes No
2

If you answered Yes to the above question, please provide your license number and expiration date in the space below.  If you do not possess a certificate of eligibility, please indicate N/A in the text box below.

3

Do you possess a master's degree in Occupational Therapy?

Yes No
4

Describe your experience in Occupational Therapy.

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.

5

Describe your supervisory experience in Occupational Therapy.

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.


Powered by JobAps