Cherokee County, Texas Health Department - Application for Employment Page 4 of 5 Pages

Other Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experience.

Specialized Skills Check Skills/Equipment Operated

Other Software Applications

____ PC ____ Microsoft^TM Word (list): Other (list)

____ Calculator ____ Microsoft^TM Xcel ___________________ ____________

____ Typewriter ____ Microsoft^TM Access ___________________ ____________

____ Fax ____ Microsoft^TM Powerpoint ___________________ ____________

____ Adobe^TM ____ Microsoft^TM Publisher ___________________ ____________

State any additional information you feel may be helpful to us in considering

your application.

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN

INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing in a reasonable manner the activities

involved in the job or occupation for which you have applied? A

description of the activities involved in such a a job or occupations is

attached. ____YES ____NO

References

1. ( )

(Name) Phone #

(Address)

2. ( )

(Name) Phone#

(Address)

3. ( )

(Name) Phone#

(Address)