The purpose of this Supplemental Questionnaire is to obtain specific information regarding your experience as related to the position of a Occupational Therapist. We are recruiting for an Occupational Therapist interested in working in a Psychiatric OT environment.
1
Do you possess a valid Occupational Therapy license issued by the CALIFORNIA Board of Occupational Therapy (CBOT)
Yes
No
1a
If you have a California license, please indicate the License Number and the expiration date. Write N/A if not applicable.
1b
If you have an Acceptance Letter for the next licensing exam, please indicate the exact date (MM/DD/YYYY). You may be asked, at a later time, to provide a copy of this letter. Write N/A if not applicable.
2a
I have some experience working in a Psychiatric Occupational Therapy environment
Yes
No
2b
I am interested and willing to work in a Psychiatric Occupational Therapy environment.
Yes
No
CERTIFICATION:
I hereby certify that I am the author of this application and that all information presented is true and based on my background, skills and experiences. I understand that any false, incomplete, or incorrect statement may result in my disqualification or dismissal from employment with the City and County of San Francisco.
Department of Human Resources