Official SealSan Joaquin County Human Resources Division


#0119-RS1015-01
Supplemental Questionnaire

Last Name
First Name

 

Please complete the following supplemental questionnaire. This questionnaire is considered an extension of your employment application and will be reviewed to help assess your qualifications. Resumes are not accepted in lieu of completing this questionnaire.


1.

Did you graduate from an accredited four year college or university with a major in psychology, social work, business or public administration, or a closely related field?

Yes No
 

If Yes, please provide the following information:

  • Name of college or university from which you graduated
  • Degree obtained
  • Major
2.

Please describe your four years of full time, paid, increasingly responsible counseling or program management experience in a substance abuse or social crisis program, which includes one year at a level equivalent to Substance Abuse Program Manager in San Joaquin County service.

Include the name of your employer, dates of employment, job title, and number of hours worked per week.

3.

SUBSTITUTION PATTERN

A master's degree in social work, public health, public administration or a closely related field may substitute for one (1) year of the required experience.  Do you have a master's degree in one of these areas?

Yes No
 

If Yes, please provide the following information:

  • Name of college or university from which you graduated
  • Degree obtained
  • Major
4.

This position requires possession of a valid California driver's license.  Please provide your license number and expiration date.