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Supplemental Questionnaire

Last Name
First Name




Supplemental Questionnaire

This supplemental questionnaire is required to be completed in addition to the standard application.  Do not refer to a resume in lieu of completing the supplemental questionnaire and the standard application.  If a response does not apply to you, indicate "N/A" in the text box.


This position requires possession of a bachelor's degree from an accredited college or university, including 30 semester units of basic science.

In the space provided below, please confirm that you have met this requirement by indicating the university and type of degree you have completed. Also include a list of the basic science courses you have completed and the units obtained from each course.


Special Qualification: At the time of application, candidates must possess an evaluation letter from the State of California, Department of Health Services, stating that eligibility and educational requirements for acceptance as an Environmental Health Specialist Trainee have been met.

This letter must be submitted with your application to qualify for this position.

Do you possess the State of California, Department of Health Services eligibility letter?


Yes No


If you checked "Yes" to Question 2, attach a copy of your evaluation letter in the Resume section of the application.  Our application system allows for only one document to be uploaded, so if you are attaching a resume or cover letter, scan all documents into one document before uploading.  Failure to attach your letter may cause your application to not be accepted.


Do you possess a valid California driver's license?

Yes No