Official SealDepartment of Budget and Management


#17-009471-0006
Supplemental Questionnaire

Last Name
First Name
1

Please indicate your American Sign Language skill level

a. Polite (able to greet and exchange pleasantries; indicate or understand an emergency)
b. Literate (understands a conversation and can respond)
c. Fluent (is your native language or can converse in the language as if it was your native language.)
d. Do not speak sign language.
2

Please check the position for which you would like to be considered

a. Early Childhood Education Dept. - Birth - 5 years
b. Elementary Department
C. Middle School
d. High School
e. Reading Specialist
f. Special Needs/Enhanced Services Programv
g. Technology Education (theatre, media, art)

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