Official SealSan Joaquin County Human Resources Division


#1222-RO6105-FL
Supplemental Questionnaire

Last Name
First Name

 

The following information is being collected to identify the type of departments you are interested in working for. You will only be referred to jobs that meet the conditions you specify below so give careful consideration to your choices.


1.

Please mark each county department type that you are willing to accept job referrals to:
All Departments
General County Government
Health Care Services
San Joaquin General Hospital
Law Enforcement
2.

In addition to the day shift, check the following shifts that you are available to work:
Nights
Graveyards
Weekends
Holidays
Rotating (Depending on the department, rotations may occur on a monthly, quarterly or annual basis)
None of the above

 

The following information will not be used for screening purposes, it will only be used for specific certification needs.
3.

Are you currently employed by San Joaquin County?
Yes No
 

If you answered yes, please provide: 

  • Your employee ID
  • Current department
  • Current job title
4.

Are you proficient in a language(s) other than English?
Yes No
 

If you answered yes, please list the language(s) you are proficient in other than English: