2009 TANF Trainee Profile Form

Please complete the following information about yourself. This information will be used only for registration into the TANF Training Program. Please complete and return electronically. If you have any questions, please call the TANF Training staff at 501-683-5370 or email devona.caples@arkansas.gov.

Name


A red asterisk (*) indicates required questions.


  1. Middle Initital*


  1. Personnel Number*


  1. ANSWER User ID


  1. Job Title *


  1. Comments (Dual Roles - Stationed at another office) Please list:


  1. Local Office  *


  1. Email Address*


  1. Office Phone (xxx-xx-xxx)*


  1. Office Fax*


  1. Home Phone


  1. Cell Phone*


  1. Immediate Supervisor*


  1. Supervisor Email*


  1. Supervisor Phone*


  1. Supervisor Fax*


  1. What is your past work experience?*
    TEA
    WIA
    Education
    Medicaid
    Private Industry
    Private Industry
    Food Stamps
    Social Work
    AJL
    Child Support
    DWS


  1. Date of hire in TEA Program?*


  1. What is the highest level of education you have achieved?  *


  1. Select all program categories that you work with in your daily job duties.*
    TEA
    AJL
    Child Care
    Work Pays
    Case Management
    Job Development
    Clerical
    Supervisory