Application for Employment

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.
Name:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
Email address:
Position applying for:
Date available for employment:
Have you ever filed an application with CJI?
Yes              No
If yes, what was your name at that time?
   
Educational History  
High School or GED completed?
Yes              No
If "No", number of years completed:
   
College#1 Name:
College#1 Address:
College#1 Dates attended:
College#1 Major subject:
College#1 Degree received:
 
College#2 Name:
College#2 Address:
College#2 Dates attended:
College#2 Major subject:
College#2 Degree received:
 
College#3 Name:
College#3 Address:
College#3 Dates attended:
College#3 Major subject:
College#3 Degree received:
 
College#4 Name:
College#4 Address:
College#4 Dates attended:
College#4 Major subject:
College#4 Degree received:
 
College#5 Name:
College#5 Address:
College#5 Dates attended:
College#5 Major subject:
College#5 Degree received:
   
Special Skills and Training
List any skills and special training not indicated in the Educational History section such as equipment operation, software, typing, etc.
Skill 1:
Skill 2:
Skill 3:
Skill 4:
Skill 5:
Skill 6:
Skill 7:
Skill 8:
Skill 9:
Skill 10:
Skill 11:
Skill 12:
   
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.
Current or most recent Employer#1:
Address:
Phone number:
Begin date:
End date:
Job Title:
Type employment:
Full-Time    Part-Time    Other
Beginning salary:
Ending salary:
Supervisor name:
Reason for leaving?


Duties performed:
   
Employer#2:
Address:
Phone number:
Begin date:
End date:
Job Title:
Type employment:
Full-Time    Part-Time    Other
Beginning salary:
Ending salary:
Supervisor name:
Reason for leaving?


Duties performed:
   
Employer#3:
Address:
Phone number:
Begin date:
End date:
Job Title:
Type employment:
Full-Time    Part-Time    Other
Beginning salary:
Ending salary:
Supervisor name:
Reason for leaving?


Duties performed:
   
Employer#4:
Address:
Phone number:
Begin date:
End date:
Job Title:
Type employment:
Full-Time    Part-Time    Other
Beginning salary:
Ending salary:
Supervisor name:
Reason for leaving?


Duties performed:
   
Employer#5:
Address:
Phone number:
Begin date:
End date:
Job Title:
Type employment:
Full-Time    Part-Time    Other
Beginning salary:
Ending salary:
Supervisor name:
Reason for leaving?


Duties performed:
   
Employer#6:
Address:
Phone number:
Begin date:
End date:
Job Title:
Type employment:
Full-Time    Part-Time    Other
Beginning salary:
Ending salary:
Supervisor name:
Reason for leaving?


Duties performed:
   
   

Employment
Comments:
May we contact all current/previous employers?
Yes              No
Please do not contact (who):
Provide any other names under which you have been employed.
If you are under 18 years of age, can you provide required proof of eligibility to work?
Yes              No                  N/A
Can you provide proof of citizenship or authorization to work in the U.S. upon employment?
Yes              No
Have you been convicted of a felony within the last ten years? (Conviction will not necessarily prevent you from obtaining employment.)
Yes              No
If yes, please comment:
Do you have any relatives working for the Criminal Justice Institute?
Yes              No
If yes, what is the relationship?
   
   
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.
Reference#1 Name:
Address:
Phone:
Comments:
   
Reference#2 Name:
Address:
Phone:
Comments:
   
Reference#3 Name:
Address:
Phone:
Comments:
   
Reference#4 Name:
Address:
Phone:
Comments:
   
Military Experience  
Have you served in the U.S. Armed Forces or National Guard?
Yes              No
If yes, what branch?
Dates of Service:
Describe duties and special training:
   

State of Arkansas
Statement of Selective Service Status
In Compliance with Act 228 of the 1997 Acts of the Arkansas General Assembly
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:
       I am female;
       I am a current member of the armed forces on active duty;
       I am under 18 years of age;
       I am 26 years of age or over;
       I am an exempted resident alien;
       Other
   
Employee Disclosure and Certification
The University of Arkansas Board of Trustees Policy 330.1, Employee and Contractor Conflict of Interest prohibits University transactions with or employment of persons that meet certain qualifying factors without the approval of a high-ranking University official.  To avoid either a possible violation of Board Policy 330.1 or the appearance of a conflict of interest, prior to hiring an individual, documentation must be submitted to the Director of the Criminal Justice Institute for review.  Approval to hire shall be considered in consultation with the Vice President for University Relations and Administration for the University of Arkansas System.
   
I understand that to be eligible for employment with the Criminal Justice Institute, University of Arkansas System, I must be in compliance with the University of Arkansas Board of Trustees Policy 330.1.  I therefore certify that:

    1. I have listed below if I am a current or former member of the Arkansas General Assembly, current or former constitutional officer, or state employee.

    2. I have listed below if my spouse, brother, sister, parent or child of me or my spouse is a member of the Arkansas General Assembly, a constitutional officer, or state employee.

    3. I understand that I cannot enter into any Professional Consulting Services Contracts with any state agency.

 

Indicate below if you, your spouse or the brother, sister, parent, or child of you or your spouse is a current or former member of the General Assembly, Constitutional Officer, or State Employee:

    

     Check if none of the above applies (skip to Certification)









General Assembly		 1.     Current       Former
2.     Current       Former
3.     Current       Former
Name of Position or Job Held
1.
2.
3.
Term(s) of Office or Dates of Employment
1.
2.
3.
Persons' name and relationship to you.
Indicate "self" if applicable.
1.
2.
3.
 









Constitutional Officer		 1.     Current       Former
2.     Current       Former
3.     Current       Former
Name of Position or Job Held
1.
2.
3.
Term(s) of Office or Dates of Employment
1.
2.
3.
Persons' name and relationship to you.
Indicate "self" if applicable.
1.
2.
3.
 









State Employee		 1.     Current       Former
2.     Current       Former
3.     Current       Former
Name of Position or Job Held
1.
2.
3.
Term(s) of Office or Dates of Employment
1.
2.
3.
Persons' name and relationship to you.
Indicate "self" if applicable.
1.
2.
3.
   
Certification  
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.
Print signature of Applicant:
Application Date:

 

 

 

                                                                        

                  The Criminal Justice Institute in an Affirmative Action/Equal Opportunity Employer.