Official SealSan Joaquin County Human Resources Division


#1122-RS7010-PC
Supplemental Questionnaire

Last Name
First Name
1.

PATTERN I:

Have you graduated from an accredited four year college or university?
Yes No
2.

PATTERN II:

Do you have four years of progressively responsible experience in a recreation or social service delivery program?
Yes No
 

If you answered yes to question 4, detail your qualifying experience.  Include your job title, name of employer, dates of employment, hours worked, and relevant job duties.
 

SUBSTITUTION:

Education may be substituted for the required general qualifying experience on a year for year basis up to four years.

Are you using the substitution to qualify?
Yes No
3.

This position requires possession of a valid California Class C Driver's license.

Please list your CA Driver's license number and expiration date in the space below.