offical seal
Santa Cruz County Personnel Department
#21-BAX-WW


Supplemental Questionnaire

Last Name First Name
 
1.

I am interested in working at the outdoor Benchland’s Shelter:

Yes No

2.

I am interested in:

 


 

Expanded Site Host

 

Expanded Site Supervisor

 

IQ Assistant Site Supervisor

 

IQ Site Supervisor

 

Other Disaster Service Work


3.

I am available to work:


 

Monday

 

Tuesday

 

Wednesday

 

Thursday

 

Friday

 

Saturday

 

Sunday

4.

My hours of availability are:


5.

I am willing to work in:    


 

Santa Cruz

 

Watsonville

 

Mid-County

 

All