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Human Resources Department

Supplemental Questionnaire

Last Name First Name


This Supplemental Questionnaire will be used to determine applicants’ qualifications for this position and assess an applicant’s ability to advance in the recruitment process; therefore, applicants are encouraged to answer all questions thoroughly and completely.  Omitted information will not be considered or assumed.  Applicants who have no experience in a specific area are recommended to state "no experience in this area" instead of leaving the space blank.

Please note that the experience in your answers must be reflected in your employment history.


How many years of experience do you have assisting a licensed veterinarian in providing medical treatment to animals, including surgical procedures and medical examination, in a veterinary hospital or shelter clinic setting? 

No experience
Less than 1 year of experience
1-2 years of experience
2-3 years of experience
More than 3 years of experience

Do you have a current Registered Veterinary Technician certificate issued by the California Veterinarian Medical Board?

Yes No

I understand that a current California Registered Veterinary Technician Certificate is required for this position and I must submit the required certificate along with my application.

Yes No

Do you have a valid Class C Driver's License?

Yes No