Official SealSan Joaquin County Human Resources Division


#0423-RH5001-TM
Supplemental Questionnaire

Last Name
First Name
1.
Are you currently registered with the American Registry of Radiologic Technologists?
Yes No
 
If you responded yes, please identify your ARRT ID number.
2.
Do you have current certification by the State of California Department of Health as a Radiologic Technologist?
Yes No
 
If you responded yes, please identify your license number