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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.



Do you possess six months of work experience performing routine clerical or general office support duties in a social service employment program or agency?

Yes No

If you checked "yes" to Question 1, list the employer name, your job title, dates of employment, hours worked per week, a detailed description of your duties, and if it was paid or not.



Completion of 15 semester units at an accredited college or university may be substituted for the experience requirement.  If you are using this substitution, give the name of the school and the number of units completed.


Do you possess a valid California driver's license?

Yes No