Official SealSan Joaquin County Human Resources Division


#0620-RF0300-01
Supplemental Questionnaire

Last Name
First Name

 

THIS IS A DEPARTMENT PROMOTIONAL EXAMINATION.  IN ORDER TO BE CONSIDERED FOR THIS RECRUITMENT AN APPLICANT MUST BE CURRENTLY EMPLOYED AT SAN JOAQUIN GENERAL HOSPITAL.
1.

Are you currently employed at San Joaquin General Hospital? If yes, provide the following:

  • Employee ID number
  • Job Title
  • Department you work in
2.
Do you have six months of work experience?
Yes No
3.
If you answered yes to the previous question, please specify:

  • Job title
  • Name of facility/business
  • Specific duties
  • Dates of employment
4.
Have you completed an approved training program in general cleaning methods and procedures?
Yes No
5.

If yes, please specify:

 

  • name of program/school:
  • start of program/school:
  • date of program completion: 
  • date certificate/degree received: