Official SealSan Joaquin County Human Resources Division


#0618-RS3041-TM
Supplemental Questionnaire

Last Name
First Name
1

Do you possess a Master's Degree in Social Work (MSW) from an accredited institution?

If yes, ensure that you identify the institution in the Education portion of the application.

Yes No
2

To qualify, requires a current and valid ASW from the California Board of Behavioral Sciences (BBS).  Do you possess an ASW?

Yes No
 

Provide the ASW number.

A copy of the registration must be submitted with the completed employment application. It may be submitted when prompted for a resume, sent to msneed@sjgh.org, or fax to (209) 468-6271.

3

Candidates must possess and maintain a valid California driver's license.  Provide your valid California driver's license number and expiration date.

4

This position may require working on call status as well as weekends.  Please indicate if you are available to work this schedule.

Yes, I am available to work on call and on weekends.
No, I am unavailable to work on call and on weekends.