City and County of San Francisco

Last Name
First Name

2533 Emergency Medical Services Agency Specialist - Temporary Exempt (TEX-2533-904122)

The purpose of this Minimum Qualification Supplemental Questionnaire (MQSQ) is to obtain specific information regarding your education, experience, and/or training in relation to the minimum qualifications for this recruitment, as stated on the announcement and will be used as a tool to screen applications for the minimum qualification requirements. This Minimum Qualification Supplemental Questionnaire (MQSQ) must be completed and submitted online with the application at the time of filing. Responses to items on on the MQSQ must be supported by the information provided on the application and is subject to verification.

Please be sure to include all relevant education and experience in the work history and education sections of the application. It is essential that you provide complete information in identifying your education, experience, and training. A resume will not substitute for a completed application. If you write "See Resume" on the application or on the below questionnaire, your application may be rejected. Resumes will not be reviewed.

Note: Falsifying one's education, training, or work experience or attempted deception on the application or Minimum Qualification Supplemental Questionnaire may result in disqualification for this and future job opportunities with the City and County of San Francisco.

VERIFICATION MAY BE REQUESTED AND REQUIRED AT ANY TIME.

Do you possess a valid license as an Emergency Medical Technician-Paramedic (EMT-P) issued by the State of California?

As a reminder, all qualifying license information must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include your EMT-P license information on your application that you are about to describe in the "License and Certification" section of your application, you will not receive credit for this. If you are copying an old application, please take the time to update before submitting your application.

Yes No

Do you possess a valid license as a Registered Nurse issued by the State of California?

As a reminder, all qualifying license information must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include your RN license information on your application that you are about to describe in the "License and Certification" section of your application, you will not receive credit for this. If you are copying an old application, please take the time to update your information before submitting your application.

Yes No

How much verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P) do you have?

As a reminder, all qualifying experience must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the work experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your Employment Record before submitting your application.

Not applicable, I do not have verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

I have some but less than 1 year (2000 hours) of verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

I have at least 1 year (2000 hours) but less than 2 years (4000 hours) of verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

I have at least 2 years (4000 hours) but less than 3 years (6000 hours) of verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

I have at least 3 years (6000 hours) but less than 4 years (8000 hours) of verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

I have at least 4 years (8000 hours) but less than 5 years (10000 hours) of verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

I have 5 years (10000 hours) or more of verifiable field or clinical experience as an Emergency Medical Technician-Paramedic (EMT-P)

How much verifiable field or clinical work experience as a Registered Nurse (RN) do you have?

Not applicable, I do not have verfiable field or clinical work experience as a Registered Nurse (RN)

I have some experience, but less than 1 year (2000 hours) of verfiable field or clinical work experience as a Registered Nurse (RN)

I have at least 1 year (2000 hours) but less than 2 years (4000 hours) of verfiable field or clinical work experience as a Registered Nurse (RN)

I have at least 2 years (4000 hours) but less than 3 years (6000 hours) of verfiable field or clinical work experience as a Registered Nurse (RN)

I have at least 3 years (6000 hours) but less than 4 years (8000 hours) of verfiable field or clinical work experience as a Registered Nurse (RN)

I have at least 4 years (8000 hours) but less than 5 years (10000 hours) of verfiable field or clinical work experience as a Registered Nurse (RN)

I have 5 years (10000 hours) or more of verfiable field or clinical work experience as a Registered Nurse (RN)

CERTIFICATION: By checking this box, I certify that I am the author of this application and supplemental questionnaire and that all information is true based on my background, skills and experiences. I understand that any false, incomplete or incorrect statement, regardless of when it was discovered, may result in my disqualification or dismissal from my employment with the City and County of San Francisco. I understand and agree that any information provided is subject to verification.

Department of Human Resources

#TEX-2533-904122
Supplemental Questionnaire

Department of Human Resources

#TEX-2533-904122 Supplemental Questionnaire

#TEX-2533-904122
Supplemental Questionnaire