San Joaquin County Human Resources Division

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.

This position requires completion of 30 semester or 45 quarter units from an accredited college or university, of which a minimum of 12 semester or 15 quarter units must be in psychology, sociology, counseling, chemical dependency or closely related field.

Have you completed 30 semester or 45 quarter units from an accredited college or university?

Please provide the course numbers, titles and units of the coursework you have completed in psychology, sociology, counseling, chemical dependency or a closely related field.  Include the name of the institution(s) at which you completed the coursework, and indicate if semester or quarter units.

Note: This information must be provided.  If you possess a degree in one of the areas noted above, provide the name of the accredited college or university from which you graduated, degree obtained, and major.

This position requires current certification as an Alcohol and Other Drug (AOD) Counselor issued by a certifying agency approved by the State of California.  Certification must be maintained, as defined by the Department of Alcohol and Drug Programs, California code of Regulations, Chapter 8.  Failure to maintain certification may result in release from employment.

Do you possess a current certificate as an Alcohol and Other Drug (AOD) Counselor issued by a certifying agency approved by the State of California?

(NOTE: A copy of this certificate must be submitted with your employment application)

This position requires that you possess and maintain a valid California driver's license.  Do you possess a valid California driver's license?

If you answered Yes, please provide your license number and expiration date.

Describe your experience providing substance abuse counseling services to individuals and groups.

Include in your response the name of your employer, your job title, and dates of employment.