Official SealSan Joaquin County Human Resources Division


#0918-RP0610-01
Supplemental Questionnaire

Last Name
First Name
1

Have you earned a bachelor’s degree from an accredited four- year college or university with a major in public health or health-related field, public or business administration, the social sciences or related field? If yes, please provide the name of the institution and the specific degree earned.

2

Have you earned a master’s degree in public health or health-related field, public or business administration, the social sciences or related field from an accredited college or university?  If yes, please provide the name of the institution and the specific degree earned.

3

Do you possess 3 years of progressively responsible experience planning and executing emergency preparedness activities, including writing of plans, procedures, protocols, guidelines and exercise-related training?

Yes No
4

If yes, please provide 1) dates of employment 2) employer and 3) job title.

5

Describe your professional experience planning and executing emergency preparedness training activities.

6

Describe your professional experience in writing, reviewing and updating emergency preparedness plans.

7

Describe your experience and responsibilities in managing a program budget (include amount of operating budget).

8

Describe your professional experience in grant and contract administration.

9

Do you possess a valid California Driver’s License? If yes, please provide license number and expiration date.