Official SealSan Joaquin County Human Resources Division


#0122-RS0102-AC
Supplemental Questionnaire

Last Name
First Name
 

This position requires one year of experience equivalent to an Eligibility Worker I in San Joaquin County service. This experience must have been in a California county public assistance program within the last five years.

In the space provided below, please describe relevant work experience that meets this requirement.  Include name of employer, job title, dates of employment, and typical duties performed.

 

 

Do you possess a valid California driver's license?

Yes No
 

If you responded yes, please identify your license number and expiration date: