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Human Resources Department
#22-443170-02


Supplemental Questionnaire

Last Name First Name
 

 

This Supplemental Questionnaire will be used to determine applicants’ qualifications for this position and whether they will continue 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.



1

Please indicate your years of public assistance benefits experience:


 

CalFresh

1-3
3-5
5 or more
No experience, but willing to learn
 

Medi-Cal

1-3
3-5
5 or more
No experience, but willing to learn
 

CalWorks

1-3
3-5
5 or more
No experience, but willing to learn
2

Please indicate if you are knowledgeable and experienced with CalWIN system.

Yes
No
3

Please indicate if you are knowledgeable about the CalSAWS Project.

Yes
No
4

Some positions may require bilingual skills.  Applicants who indicate bilingual skills in their application may be required to demonstrate proficiency in speaking, reading and writing in the language indicated.

Are you proficient in speaking, reading and writing any of the following languages? (select all that apply)   

                 

Spanish
Tagalog
Vietnamese