Official SealDepartment of Budget and Management


#17-001570-0001
Supplemental Questionnaire

Last Name
First Name

 

**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 have a minimum of a Bachelor's degree in a Health or Human Services counseling field OR a Bachelor's degree in a program of study with a counseling emphasis AND 1 credit in Alcohol and Drug Ethics?  If yes, you must submit a copy of your transcripts documenting the completed coursework with your application.

Yes No
2

In which field of study is your degree? If you do not have a degree, enter N/A.

3

Do you possess a current license as a Licensed Graduate Alcohol and Drug Counselor (LGADC) from the Maryland Board of Professional Counselors and Therapists?

Yes No
4

If you answered Yes to the previous question, please provide the license number and expiration date in the box below.  A copy of your current license or license verification should also accompany your application.


Powered by JobAps