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Human Capital Management
#190108-H16C-01


Supplemental Questionnaire

Last Name First Name
 

 

OK Department of Human Services (DHS) requires that the following questions be answered before continuing with the application.


1.

Do you have legal status to work in the United States?

Yes No
2.

Have you had a protective order entered against you pursuant to the Oklahoma
Protection from Domestic Abuse Act or a similar statute of another state? 

If yes, provide the name of the court and court number in the text area:

If no, please enter No in the text area:            

3.

DHS policy does not allow some family members to be employed within the same supervisory group or unit. Please list the names of all of your relatives now employed by DHS:

If no, please enter No in the text area:

4.

Have you ever been terminated or resigned from employment in lieu of being terminated?  
If yes, explain circumstances:      

If no, please enter No in the text area:

 

Do you have one year of clerical experience in a governmental or non-profit social services provider environment PLUS two additional years of clerical experience in a child welfare environment or an equivalent combination of education and experience, substituting thirty semester hours of college for each year of the required experience?

Yes No

 

ATTENTION!

 Please verify that you meet the education and experience requirements listed in the job bulletin before completing the following supplemental questionnaire. The questions below will be used for scoring purposes, in lieu of a written exam.


 

Check the box that represents your highest level of education.

I have a Bachelor's degree or higher.
I have an Associate's degree.
I have completed some college courses but do not have a degree.
I have a high school diploma or GED
I have none of the education listed above.
 

Please list the college or university where you gained your education as indicated in the response above.  If you indicated "no education", then please type N/A below. 

 

What experience do you have researching and gathering information?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

Please check all of the following areas in which you have taken college classes.

social work
psychology
child development
communication
I have not taken classes on any of the above.
 

Please list the school and location where you gained your education as indicated in the response above.  If you indicated "no education", then please type N/A below. 

 

Please check all of the following computer programs you have experience using.

Microsoft Word or similar word processing software
Microsoft Excel or similar spreadsheet software
Microsoft Outlook or similar email program
I have no experience with any of the above.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

 

What experience do you have drafting written documents?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have planning, developing and organizing all phases of your own work?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have in solving problems or resolving conflicts?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What is your highest level of experience in working as part of a team?

I have led a team or group project.
I have been a member of a team or group project.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What is your experience providing customer service to the public?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have reading and interpreting detailed instructions?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have conducting multiple tasks simultaneously and meeting firm deadlines for those tasks?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have following safety procedures during an emergency situation such as a medical emergency, car trouble, or fire?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have maintaining confidential files or information?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have advising the public of available community resources for assistance, such as day care or medical care?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
 

What experience do you have recruiting, screening, evaluating, and recommending volunteers?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have communicating with others on a professional level?

I have performed this task independently.
I have performed this task under supervision.
I am familiar with this task or have received some training or education on it.
I have no experience with this task.
 

Please list the school and location or employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below.