Official SealSan Joaquin County Human Resources Division


#0123-RS0105-DP
Supplemental Questionnaire

Last Name
First Name
1.

This is a departmental promotional recruitment. Qualified applicants must currently be employed with the San Joaquin County Human Services Agency and meet the promotional eligibility requirements as stated in Civil Service Rule 10, Section 3.

Are you currently employed with the San Joaquin County Human Services Agency?
Yes No
2.

Provide your employee ID number.
3.

PATTERN I

Do you possess three years of experience equivalent to an Eligibility Worker II in San Joaquin County service? 

Yes No
4.

If you answered yes to question 3, please provide the dates of experience at the Eligibility Worker II level.
5.

PATTERN II

Do you possess one year of experience equivalent to an Eligibility Worker III in San Joaquin County service?

Yes No
6.

If you answered yes to question 5, please provide the dates of experience at the Eligibility Worker III level.
7.

Possession of a valid California driver's license may be required by the nature of the assignment.  Do you have a valid California driver's license?

 
Yes No