Official SealSan Joaquin County Human Resources Division


#1122-RS1075-01
Supplemental Questionnaire

Last Name
First Name
1.

Did you graduate from an accredited four-year college or university?

Yes No
 

If you responded yes, please identify the name of the college or university attended and the major the Bachelor's degree was awarded.

2.

Do you have three (3) years experience providing social service work for children in a children's shelter, group home or similar setting; or providing social casework for children and families?  If yes, please include name of employer, dates of employment, job title, hours worked per week, and specific duties performed. 

3.

Do you possess a valid California driver's license?  If yes, please provide your valid California driver's license number and the expiration date.