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#TEX-9924-088179
Supplemental Questionnaire

Last Name
First Name

 

All applicants are required to complete the supplemental questionnaire as part of the online application process. The purpose of the supplemental application is to determine whether applicants possess the minimum qualifications and the desired qualifications for the 9924 Public Service Aide (Climate and Health Program Trainee) position. This information should be consistent with your application (i.e. must be included in the Education and Training and Employment Record sections) and is subject to verification.


1a.

Select the statement that best matches the highest level of education you have completed.

Possession of a high school diploma or equivalent
Possession of a Bachelor's Degree from an accredited college or university
Possession of a Master's Degree or higher from an accredited college or university
None of the above
1b.

Referring to your response in Question #1a, please provide the name of the school you attended and the field of study for each degree you completed. If this does not apply to you, please type "N/A" in the box below.

2a.

How much verifiable full-time equivalent experience do you have working in public health, community planning and assessment, or community outreach and engagement? (Full-time is equivalent to 40 hours per week.)

No experience
Less than 1,000 hours
1,000 to 1,999 hours
2,000 or more hours
2b.

Please provide the name of the organization(s) and the dates (e.g. MM/YYYY – MM/YYYY) where you obtained your verifiable work experience as indicated in Question #2a.

In addition, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you selected that you do not have experience, please type N/A.

Do not type “See Resume.”

 

CERTIFICATION: I hereby certify that all information is true and based on my education, training, skills, and experience. I understand that any false or incorrect statement may result in my disqualification of the selection process for this position and/or dismissal from employment with the City and County of San Francisco. I also understand and agree that any information provided is subject to verification.