Career Pathways Initiative Program Application

Saturday, December 21, 2024

Career Pathways Initiative Program

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

Last Name:

First Name:

Middle Name:

Maiden:

UA-PTC E-mail Address:

Personal E-mail Address:

UA-PTC Student ID:

Date of Birth:

Physical Address:

Apartment Number:

Mailing Address:

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

Apartment Number:

Cell Phone:

Home Phone:

County:

Emergency Contact Name:

Emergency Contact Number:

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

Status/Benefits

Race:

Asian/Pacific Islander

Black (Non-Hispanic Origin)

Hispanic

American Indian/Alaska

Non-resident Alien

White (Non-Hispanic Origin)

Other

Marital Status:

Single

Married

Divorced

Legally Separated

Gender:

Male

Female

Unknown

Other Gender

Check all that you currently receive:

Food SNAP

Medicaid (including ARKids)

TEA / Work Pays

SSI/SSD

Unemployed

Other Income

Housing status:

Rent

Mortgage

HUD

Own

Other

How do you pay your bills and support your family?

Self

Boyfriend/Girlfriend

Spouse

Family/Friend

Other