**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1.
Do you possess a current license as a Registered Nurse from the Maryland State Board of Nursing, or a license recognized by the Multi-State Compact agreement?
Yes
No
2.
Please provide your license number and expiration date in the box below.
3.
Describe your knowledge and experience in nursing case management.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
4.
Describe your experience with communicable diseases.
Include name of employer, job title, dates of employment, and hours worked per week for each relevant position. This experience must be reflected in your application. If you do not have this experience, put N/A in the box below.
Department of Budget and Management