Official SealSan Joaquin County Human Resources Division


#0822-RH4453-DP
Supplemental Questionnaire

Last Name
First Name
1.

This is a departmental promotion. Qualified applicants must currently be employed with a San Joaquin County Health Care Services department (BHS, CHS, EMS, HCS Admin, Neighborhood Preservation, Medical Examiner, Public Guardian, PHS, Veteran's Services) and meet the promotional eligibility requirements as stated in Civil Service Rule 10, Section 3-Eligibility for Promotional Examinations.

 

Please provide your employee ID and current County Department:
2.

Have you completed a recognized Pharmacy Technician training program?
Yes No
 

If you answered yes to question above, identify the name of the educational institution and the program completion date.
3.

Do you possess two years of experience equivalent to Pharmacy Technician II in San Joaquin County?
Yes No
 

If you answered yes to question above, identify the following:

  • Name of employer
  • Position title
  • Duties
  • Average hours worked per week
  • Timeline of employment
4.

Do you possess a valid certificate of registration as a Pharmacy Technician issued by the State of California Board of Pharmacy?
Yes No
 

If you answered yes to question above, identify the certification number and the expiration date.
5.

Do you possess a valid certificate of registration as a Pharmacy Technician issued by the Pharmacy Technician Certification Board?
Yes No
 

If you answered yes to question above, identify the certification number and expiration date.
6.

SUBSTITUTION:

Are you substituting at least least one additional year of experience as a Pharmacy Technician for the educational minimum qualification requirements of this position? Note: If you are, ensure that the additional experience is clearly identifed in your response to question #2 above.
Yes No