Official SealSan Joaquin County Human Resources Division


#0920-RE1004-FL
Supplemental Questionnaire

Last Name
First Name

 

Please complete the following supplemental questions. This supplemental is considered an extension of your employment application and will be reviewed to help assess your qualifications.



 

LICENSE/CERTIFICATION


1.

All levels require a valid California driver's license. 

Please provide your California driver's license number and expiration date (mm/dd/yyyy)

2.

Do you possess a valid Engineer-in-Training (EIT) certification issued by the California Board of Registration for Professional Engineers and Land Surveyors?

Yes No
2a.

If you answered "Yes" to Question No. 2, please provide your certification number and expiration date.

3.

Do you possess a valid Professional Engineer license as issued by the California Board of Registration for Professional Engineers and Land Surveyors?

Yes No
3a.

If you answered "Yes" to Question No. 3, pleaes provide the type of license and the license number.

4.

Please provide any other licenses/certifications you possess (e.g. Certified Floodplain Manager), if any.


 

EDUCATION


5.

Have you graduated with a four-year degree from a college/university accredited by the Accreditation Board for Engineering and Technology?

Yes No
5a.

If you answered "Yes" to Question No. 5, please provide the name of the college/university and the major in which you earned your degree.


 

EXPERIENCE


6.

Do you possess experience working as an Engineer I, Engineer II or Engineer III with San Joaquin County?

Yes No
6a.

If you answered "Yes" to Question No. 6, please provide the job title, dates of employment and Employee ID.

6b.

If you answered "No" to Question No. 6, please provide your work experience working in a progressively responsible and varied civil engineering environment.

Include the name of your employer, job title, dates of employment, number of hours worked per week, and a detailed description of the specific duties you performed.