Official SealSan Joaquin County Human Resources Division


#1024-RS4302-AC
Supplemental Questionnaire

Last Name
First Name
1.

Do you have one year of employment (2,080 hours) with San Joaquin County as a Community Health Outreach Worker Trainee? 
Yes No
2.

Do you have one year (2,080 hours) of experience providing community-based health services, working with community based organizations that provide health related services to culturally diverse groups, or working with high risk groups in area of communicable diseases?
Yes No

 

Please ensure this is CLEARLY demonstrated in the Employment Experience section of your application.

Note: resumes will not be accepted in lieu of a completed application. 
3.

Do you possess a valid California Class C driver's license?
Yes No
 

License Number AND Expiration Date