Official SealDepartment of Human Resources


#TEX-2905-090632
Supplemental Questionnaire

Last Name
First Name

 

The purpose of this Supplemental Questionnaire is to obtain specific information regarding your education, experience, and/or training. Responses to items on the Supplemental Questionnaire 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.

 

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


 

1. Based on your education, indicate the selection that best matches your highest educational attainment.

High School Diploma or equivalent (GED or High School Proficiency Examination)
Attended some college and possess 1-29 semester units / 1-44 quarter units of coursework from an accredited college/university.
Attended some college and possess 30-59 semester units / 45-89 quarter units of coursework from an accredited college/university.
Attended some college and possess 60-89 semester units / 90-134 quarter units of coursework from an accredited college/university.
Attended some college and possess 90-119 semester units / 135-179 quarter units of coursework from an accredited college/university.
Completion of a Baccalaureate Degree or higher from an accredited college/university.
 

2. Please provide the name(s) and location(s) of the institution(s) where you gained the education indicated in the question above. If you do not have any of the education above, please type "N/A".

 

3. How much verifable work experience do you have with clerical work which includes the following: use of computer applications to input and retrieve information; regular public contact to provide assistance or acquire detailed personal or confidential information; and interpreting and applying rules, regulations and policies.

I do not possess any of this experience.
I possess less than 1 year (2000 hours) of this experience.
I possess less than 2 years (4000 hours) of this experience.
I possess at least 2 years (4000 hours) or more of this experience.
 

4. List the name of your Employer(s), your Job Title(s), your Supervisor's name, and his or her contact information along with the dates of employment where you gained the experience indicated in the question above.

If you do not have any experience, type "N/A" in the box below.

 

5. How much verifiable work experience do you have determining eligibility for health and/or social services programs, loans, financial assistance, unemployment or veterans benefits?

I do not possess any of this experience.
I possess less than 1 year (2000 hours) of this experience.
I possess at least 1 year (2000 hours) or more of this experience.
 

6. List the name of your Employer(s), your Job Title(s), your Supervisor's name, and his or her contact information along with the dates of employment where you gained the experience indicated in the question above.

If you do not have any experience, type "N/A" in the box below.

 

Certification.  I hereby certify that I am the author of this application and that all information 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. I understand that any information provided is subject to verification.