Official SealSan Joaquin County Human Resources Division


#0523-RC0500-AC
Supplemental Questionnaire

Last Name
First Name
1.

Do you possess a valid California driver's license?
Yes No
1a.

If you answered "Yes" to Question No. 1, please provide your driver's license number and expiration date.
2.

This recruitment may be used to fill future full-time, part-time and/or temporary Maintenance Worker positions.  Please indicate ALL of the types of employment you are willing to accept:
Full-time
Part-time
Temporary
3.

The Department may choose to use this list to refer names by using a department promotional certification.

Are you currently employed by the San Joaquin County Public Works Department?
Yes No
3a.

If you answered "Yes" to Question No. 3, please indicate your current job title and Employee ID.