Official SealSan Joaquin County Human Resources Division


#0219-RP0602-01
Supplemental Questionnaire

Last Name
First Name
1.

Do you have a four year college or university degree with a major in public or business administration, emergency management, or closely related field?

Yes No
1A.

If you answered yes, please state college or university name and what area of study you completed for your bachelor's degree.

2.

Do you have one year of experience in writing or implementing emergency plans, procedures, and policies for emergency response or disasters?

Yes No
2A.

If you answered yes, please describe your experience below.  Please indicate job title, employer name, dates of employment, hours worked per week and description of duties.

3.

Do you have 60 semester units from an accredited college or university of which at least six units must have been in public or business administration, emergency management or composition courses?

Yes No
3A.

If you answered yes, please provide college or university name, name of courses completed and number of units per course completed.

4.

Do you have three years of experience in writing or implementing emergency plans, procedures, and policies for response to emergency incidents or disasters?

Yes No
4A.

If you answered yes, please describe your experience below.  Please indicate job title, employer name, dates of employment, hours worked per week and description of duties.

5.

Please list all training completed below (include SEMS/NIMS/ICS)

6.

Please indicate your department interest as an Emergency Planner:

I am interested in employment in the Emergency Services Division of the General Services Department
I am interested in employment in the Public Health Services Department
I am interested in working in both departments