offical seal
Santa Cruz County Personnel Department
#20-BAX-VV


Supplemental Questionnaire

Last Name First Name
 

1.

I am interested in the:


 

Expanded Site Host

 

Expanded Site Supervisor  

 

IQ Assistant Site Supervisor

 

IQ Site Supervisor

 

Other Disaster Service Work


2.

I am available to work:    


 

Monday

 

Tuesday

 

Wednesday

 

Thursday

 

Friday

 

Saturday

 

Sunday

3.

My hours of availability are:


4.

I am willing to work in:    


 

Santa Cruz

 

Watsonville

 

Mid-County

 

All