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Human Capital Management

Supplemental Questionnaire

Last Name First Name


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


Please select the option that describes your current or most recent employment status in the classified service with the State of Oklahoma.

Current DHS employee
Current employee of another State of Oklahoma agency (not DHS)
Former employee of DHS or another State of Oklahoma agency (reinstatement)
None of the above

Please verify that your employment status as indicated above is/was as an employee with permanent status in the classified service.

Yes No

If you indicated that you worked at another State of Oklahoma agency, please type the name of that agency in the box.  If you worked at DHS, please type DHS in the box. If you indicated that you have not held permanent status in the classified service, please type N/A in the box.


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

Yes No

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:            


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:


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:


Please make sure that you attach all requested documents to your application, if requested.  Resumes should be attached to the "Resume" tab and any other requested documents to the "Other" tab.