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Notice: Applications
filed do not create a contract of
employment with the Criminal Justice
Institute (CJI) or the University of
Arkansas System. If you are hired,
employment is not for any definite
period of time. All employees of CJI
whether full-time, part-time, extra help
or otherwise, may be terminated at any
time or be dismissed for cause under
University procedures.
Please answer all questions and use
correct spelling, punctuation, etc, etc.
Note: You must complete the form and
"Press the Submit button" at the bottom
for the information to be submitted.
Once submitted, you will be taken to the
confirmation page. |
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| Last Name: |
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| Address: |
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Home Phone: |
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Work Phone: |
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Cell Phone: |
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Email address: |
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Position applying for: |
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Date available for
employment: |
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Have you ever filed an
application with CJI? |
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If yes, what was your
name at that time? |
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Educational History |
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High School or GED
completed? |
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If "No", number of years
completed: |
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College#1 Name: |
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College#1 Address: |
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College#1 Dates attended: |
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College#1 Major subject: |
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College#1 Degree received: |
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College#2 Name: |
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College#2 Address: |
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College#2 Dates attended: |
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College#2 Major subject: |
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College#2 Degree received: |
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College#3 Name: |
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College#3 Address: |
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College#3 Dates attended: |
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College#3 Major subject: |
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College#3 Degree received: |
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Special Skills and Training
List any skills and special training not
indicated in the Educational History
section such as equipment operation,
software, typing, etc. |
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Skill 1: |
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Skill 2: |
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Skill 3: |
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Skill 4: |
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Skill 5: |
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Skill 6: |
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Skill 7: |
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Employment Experience
Starting with your current or most
recent employer and working backward,
please give complete full-time and
part-time employment history and any
other relevant work experience. Explain
and gaps in employment in the comments
section. Volunteer experience may be
listed in the absence of paid
employment. |
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Current or most recent Employer#1: |
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Address: |
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Phone number: |
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Begin date: |
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End date: |
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Job Title: |
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Type employment: |
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Beginning salary: |
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Ending salary: |
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Supervisor name: |
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Supervisor Email address: |
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Reason for leaving? |
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Duties performed: |
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Employer#2: |
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Address: |
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Phone number: |
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Begin date: |
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End date: |
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Job Title: |
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Type employment: |
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Beginning salary: |
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Ending salary: |
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Supervisor name: |
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Supervisor Email address |
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Reason for leaving? |
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Duties performed: |
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Employer#3: |
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Address: |
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Phone number: |
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Begin date: |
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End date: |
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Job Title: |
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Type employment: |
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Beginning salary: |
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Ending salary: |
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Supervisor name: |
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Supervisor Email address: |
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Reason for leaving? |
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Duties performed: |
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Employment
Comments: |
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May we contact all
current/previous employers? |
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Please do not contact
(who): |
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Provide any other names
under which you have been employed. |
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If you are under 18 years
of age, can you provide required proof
of eligibility to work? |
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Can you provide proof of
citizenship or authorization to work in
the U.S. upon employment? |
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Have you been convicted
of a felony within the last ten years?
(Conviction will not necessarily prevent
you from obtaining employment.) |
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If yes, please comment: |
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Do you have any relatives
working for the Criminal Justice
Institute? |
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If yes, what is the
relationship? |
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Employment References
Please list any individuals that can
be contacted to provide a professional
reference for you. You must complete the
Employment Consent and Release section
below before any references can be
contacted. |
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Reference#1 Name: |
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Address: |
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Phone: |
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Relation to you: ex.
supervisor |
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Email Address: |
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Comments: |
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Reference#2 Name: |
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Address: |
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Phone: |
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Relation to you: ex.
supervisor |
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Email Address: |
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Comments: |
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Reference#3 Name: |
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Address: |
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Phone: |
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Relation to you: ex.
supervisor |
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Email Address: |
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Comments: |
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Military Experience |
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Have you served in the
U.S. Armed Forces or National Guard? |
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If yes, what branch? |
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Dates of Service: |
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Describe duties and
special training: |
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State of Arkansas
Statement of Selective Service Status
In Compliance with Act 228 of the 1997
Acts of the Arkansas General Assembly |
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I understand that to be
eligible for employment with the State
of Arkansas, I must register, or be
exempt from registration, with the
Selective Service System in accordance
with the Military Selective Service Act,
50 U.S.C. Appx. s.s 451 et seq., as
specified in Act 228 of the 1997 Acts of
the Arkansas General Assembly. I
therefore swear or affirm under penalty
of perjury that I have registered with
the Selective Service system, or I am
exempted from such registration because
of one of the following provisions of
the Military Selective Service Act or
Act 228 of the 1997 Acts of the General
Assembly: |
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I am female; |
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I am a current member of the armed
forces on active duty; |
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I am under 18 years of age; |
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I am 26 years of age or over; |
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I am an exempted resident alien; |
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Other |
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Certification |
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I certify that the
information given herein is true and
complete to the best of my knowledge. I
understand that a representative of the
Criminal Justice Institute may verify
the information in the event of
employment, and I understand that false
or misleading information given in my
application or interview(s) may result
in termination. I also understand that I
am required to abide by all rules and
regulation of the employer.
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Signature: |
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Application Date: |
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