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Supplemental Questionnaire

Last Name
First Name

This position requires a Bachelor's degree from an accredited college or university with a major in social or behavioral sciences, criminal justice, or related field.

In the space provided below, please list the college you attended, degree received, and major.



This positon requires one year of experience in a custody setting providing counseling or social services to inmates or the equivalent of one year of an intensive internship in a custody setting providing services to inmates.

Please describe how you meet this criteria below.  Please include name of employer, job titile, job duties, and dates of employment in your response.



This postion requires possession of a valid California Class C driver's license.

Please list your CA Driver's License number and expiration date in the space provided below.