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Career Pathways Initiative Program Application

Sunday, December 15, 2019

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Please read the following before submitting this application:

  • All applicants must have a goal of employment in accordance with Arkansas Act 514.
  • Due to the high volume of applications received, priority is given to current TEA participants and students enrolled in high-wage/high-demand areas of study.
  • 1 Personal Information
  • 2 Children
  • 3 Status/Benefits
  • 4 Education
  • 5 Employment
  • 6 Submit Application

The following information is requested to determine eligibility to participate in the Career Pathways Initiative (CPI). You will be contacted with more information about the program if you appear eligible to participate.

Personal Information

*Skip, if your physical address is the same as your mailing address.

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  • 1 Personal Information
  • 2 Children
  • 3 Status/Benefits
  • 4 Education
  • 5 Employment
  • 6 Submit Application

Children

Do you have any children, 21 years old or younger?

If you answered yes, please complete the following:



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  • 1 Personal Information
  • 2 Children
  • 3 Status/Benefits
  • 4 Education
  • 5 Employment
  • 6 Submit Application

Status/Benefits

Race:
Marital Status:
Gender:
Check all that you currently receive:
Housing status:
How do you pay your bills and support your family?
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  • 1 Personal Information
  • 2 Children
  • 3 Status/Benefits
  • 4 Education
  • 5 Employment
  • 6 Submit Application

Education

Did you graduate?

Did you graduate?

Did you graduate?

Did you graduate?

Are you currently enrolled in classes?
What term do you plan to enroll at UA - Pulaski Tech?
What degree and or certificate do you plan to complete?
Have you applied for Financial Aid (Pell Grant)?
Do you receive student loans?
Are you in default on a student loan?
Do you owe money to another college?
What is your ultimate goal after completing your education at UA - Pulaski Tech?
Have you been in Career Pathways before?
If no, how did you hear about Career Pathways?
What certificate/degree/etc. Will you have already completed upon entry to this program?
Previous
  • 1 Personal Information
  • 2 Children
  • 3 Status/Benefits
  • 4 Education
  • 5 Employment
  • 6 Submit Application

Employment

Current Employment Status:
May we contact your previous employer/supervisor for a reference?

May we contact your previous employer/supervisor for a reference?

May we contact your previous employer/supervisor for a reference?

Professional References


Previous
  • 1 Personal Information
  • 2 Children
  • 3 Status/Benefits
  • 4 Education
  • 5 Employment
  • 6 Submit Application

Submit Application

By signing my electronic signature below, I give full permission for the Career Pathways Staff at UA - Pulaski Technical College to verify any information listed in this application, review my financial and academic record including but not limited to my FAFSA application, test scores, transcripts, and participation with the DHS/DWS Programs. I also give permission for CPI to contact the references and previous supervisors that have been provided on this application. This information will be used to determine eligibility to participants in CPI.

By signing my electronic signature below, I understand participation in CPI may be revoked at any time due to falsifying any information or engaging in inappropriate behavior. I also recognize that Career Pathways is not an entitlement program and that services are not guaranteed to applicants and/or participants.

I understand that typing my full name in this box constitutes a legal signature confirming that I acknowledge and agree to the understandings above.

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